Revenue Optimization Auditor (Remote)

NAPA Management Services Corporation; United States; Remote; USD 58,000 - 78,000; Full time

Benefits offered by this job

Paid Time Off

Health insurance

Life insurance

Vision insurance

Dental insurance

Disability insurance

AD&D insurance

Flexible Spending Accounts

Health Savings Accounts

401(k)

Job summary

North American Partners in Anesthesia is seeking an Auditor, Revenue Optimization to conduct audits of clinical documentation, ensure proper charge capture, and support payer audits. This role emphasizes identifying coding discrepancies and guiding improvements in the revenue cycle.

The position collaborates with cross-functional teams to implement coding guidance, develop educational materials, and support the organization’s regulatory compliance initiatives.

Qualifications

• 3+ years of medical coding experience required.
• Credential through AAPC or AHIMA required.
• One additional certification (CANPC or CPMA) within 1 year.
• Strong knowledge of CMS guidelines and Revenue Cycle processes.
• Proficient in Microsoft 365 and Excel formulas.

Responsibilities

• Audit medical records to identify missed charges, incorrect coding, and other inconsistencies.
• Perform Root Cause Analyses and report findings identifying over-/under-coding and missed billing opportunities.
• Retrieve missing patient information for billing.
• Complete coding of unbilled records identified through audits.
• Prepare reports and executive summaries of audit findings for presentation.

Skills

Coding experience

AAPC/AHIMA credential

CANPC/CPMA

Medical billing software

CMS guidelines

Microsoft 365

Excel (VLOOKUP/Pivot)

Data entry

Tools

Microsoft 365

EMR/EHR systems

Excel

Job description

Position Requirements

Sunrise,FL - USA

RESPONSIBILITIES

• Audit medical records to identify missed charges, incorrect coding, and other inconsistencies that result in missed billing opportunities.
• Perform Root Cause Analyses and report findings that identify common issues, including over-coding, under-coding and missed billing opportunities.
• Retrieves any missing patient information and documentation required for billing.
• Complete coding of unbilled records identified through audits.
• Prepare reports, executive summaries, and examples of audit findings for presentation and educational purposes.
• Assist with Clinical Documentation recommendation, coding guidance research, and the development of coding educational documents.
• Conduct ad-hoc audits as needed to provide root cause analysis and recommendations for resolution.
• Pre-payment audit: review billing vs documentation, send documentation to the payer, complete necessary charge corrections, and/or identify CDI (Clinical Documentation Improvement) opportunities.
• Provide resolution of missing documentation tasks.
• Retrieve or request necessary documents, code for billing, and data entry.
• Provide coding support to cross-functional team inquiries and special projects.

REQUIRED QUALIFICATIONS

• Minimum 3 years coding experience.
• Must have and maintain an approved coding credential through AAPC (American Academy of Professional Coders) or AHIMA.
• Must have or obtain at least one additional certification (CANPC or CPMA), within 1 year of employment.
• Extensive knowledge of medical billing software and electronic medical records.
• Well-rounded knowledge of CMS requirements claims processing, billing/coding guidelines, and the Revenue Cycle process.
• Proficient PC skills, including Microsoft 365.
• Excel proficiency to include basic formulas, concatenate, VLOOKUP, and pivot tables.

PREFERRED QUALIFICATIONS

• Previous coding experience within Anesthesia or General Surgery.
• Clinical Documentation compliance and regulatory requirements.

Total Rewards

• Salary: $58,000 - $78,000 annually
• Generous benefits package, including: Paid Time Off Health, life, vision, dental, disability, and AD&D insurance Flexible Spending Accounts/Health Savings Accounts 401(k) Leadership and professional development opportunities

The Auditor, Revenue Optimization is responsible for conducting audits and reviewing clinical documentation to ensure proper charge capture, billing in accordance with standard billing policies and compliance standards. This individual is responsible for assisting the team with resolution of coding/ billing issues, participating in external/internal audit requests, payer audits, and special projects as needed.

EEO Statement

North American Partners in Anesthesia is an equal opportunity employer. North American Partners in Anesthesia (NAPA) has evolved through more than 30 years to become a leader in anesthesia and perioperative services. Single specialty and clinician led, we remain committed to our mission of delivering exceptional patient experiences, every day.

At NAPA, we cultivate leaders, promote work-life balance, and celebrate diversity. We know your success promotes our success, and we give you the tools and programs to achieve your goals. With flexibility, a collegial and collaborative environment, a wide range of market-leading benefits, and career opportunities from coast-to-coast, your future is waiting at NAPA.