Billing Compliance Auditor

Job ID: 2024-23696 # of Openings: 1 AltaPointe Site: Administrative/Corporate Offices - Mobile Category: Accounting/Finance Position Type: Full Time Shift/Hours: Monday-Friday 8:00am-4:30pm

Responsibilities

Primary Job Functions:

Responsible for compliance within the organization

• The Billing Compliance Auditor is responsible for performing consistent medical records audits to ensure compliance with the organization's coding procedures and standards to comply with state and federal laws governing reimbursement for health care services.
• The Billing Compliance Auditor will serve as a physician educator and will provide coding and compliance training to physicians, clinical personnel, and billing staff to ensure accurate and ethical coding claims.
• Extracts relevant data from medical records and accurately reviews codes based on documentation.
• Ensures correct extrapolation of official coding and select billing guidelines to specific coding situations.
• Develops working relationships with providers and performs effective physician education regularly to ensure compliance with current coding requirements.
• Detects provider deficiencies to ensure proper communication and training.
• Upholds high level of knowledge of current coding guidelines and creates and disseminates materials and presentations to educate providers on upcoming changes to coding guidelines.
• Identifies and evaluates areas of potential risk concerning coding practices of providers.
• Maintains regular communication regarding potential areas of risk with leadership and other key partners, including but not limited to CEO, Vice-Presidents, CFO, CMO, physician leadership, Directors of Operations, Compliance and Billing.
• Assisting AHS leadership team with reports to analyze trends and target areas for improvement.
• Have a continuous work plan to include Targeted Probe and Educate audits, Recovery Audits and annual, rotating provider audits.

Courteous and respectful towards consumers, visitors, and co-workers

• Treats consumers with care, dignity, and compassion
• Respects consumers’ privacy and confidentiality
• Is pleasant and cooperative with others.
• Assists consumers and visitors as needed.
• Personal values don’t inhibit ability to relate and care for others.
• Is sensitive to the consumer’s needs, expectations, and individual differences.
• Is gently and calm with consumers, families, and others as appropriate.

Administrative and Other Related Duties as assigned:

• Actively participates in Performance Improvement activities.
• Actively participates in AltaPointe committees as requested.
• Completes assigned tasks in a timely manner.
• Treats consumers with dignity and respect
• Works in a cooperative manner with other AltaPointe employees
• Follows AltaPointe policies and procedures.
• Receives and respond to inquiries of accounting matters promptly and courteously.
• Performs financial analysis as needed.
• Assists with performance of duties of other accounting staff in periods of absence.
• Performs other duties as assigned.

Supervision and Consultation:

• Seeks supervision and consultation as needed.
• Accepts and employs directives for improvement.
• Actively works to enhance skills.

Qualifications

Bachelor’s degree in business or related field preferred but Associate in Business accepted. RHIA, CCS-P, CPMA, or CPC certification or equivalent required. Minimum of 1 year of coding experience required. Applicant should be proficient in Microsoft Office: Excel, Word, Outlook and PowerPoint and the ability to process and analyze electronic health records. Billing audit experience is preferred.