Revenue Integrity Auditor

Role Overview

• Provides charge auditing support throughout the organization to ensure integrity of charge processes and procedures from all sources.
• Collaborate with various OSUP corporate departments and OSUWMC to ensure timeliness and ensure the integrity of charging in the EPIC system.
• Performs charge audits for identified potential missed charges to determine accurate ICD10, CPT, HCPCS used for billing services provided by physicians and licensed advance practice providers.
• Identifies charge capture opportunities and works with respective departments to develop action plans for improvement.
• Works in collaboration with various OSUP and OSUWMC departments to analyze and research billing concordance opportunities.
• Coordinates with OSUP departments to ensure reconciliation and recoupment of charge opportunities.
• Maintains knowledge of regulatory and industry updates, as well as medical compliance and reimbursement policies, such as medical necessity issues and correct coding issues.
• Attends conferences, workshops, and inhouse sessions to receive updated coding information and changes in coding and/or regulations.
• Keeps up to date with EPIC features and enhancements related to charging.
• Acts as point person for professional revenue integrity program.
• Creates and participates in active formal and informal communication on behalf of OSUP with other internal and external entities/customers.
• Assists leadership in developing and monitoring charge capture methods and controls.
• Identifies, researches, and communicates operational issues.
• Participates in the development, implementation, testing, validation, and documentation of OSUP/OSUWMC revenue integrity initiative.
• Prepares, reviews, and analyzes reports to make recommendations to manager.
• Assists application developers and other support personnel with troubleshooting and resolution techniques.
• Promotes quality documentation in the medical record supporting quality coding, compliance, high quality patient care, operations, research, and reimbursement.
• Participates on committee or workgroups as needed.
• Attendance, promptness, professionalism, the ability to pay attention to detail, cooperativeness with co-workers and supervisors, and politeness to customers, vendors, and patients.

Requirements

• Associate degree in healthcare, Business, Clinical, Computer Science or related field, and or 3 years in coding and charging experience, or an equivalent combination of education and experience.
• Certification of CPC, CCS, CCS-P; or equivalent designation, along with a minimum of 3 years working with Electronic Medical Records.
• Previous experience in revenue integrity systems.
• Epic experience.

Benefits

• Medical
• Dental
• Vision
• Health reimbursement accounts
• Flexible spending accounts
• Retirement
• Employee assistance program
• Paid time off
• Holidays
• Wellness program