Revenue Cycle Audit Coordinator

Overview

This position develops, interprets, and implements operational requirements for the Centers for Medicare & Medicaid Services and has accountability for daily management, monitoring, and direction of audit activities. This position provides financial data and analysis for internal and external audits, responds to audit requests, challenges questionable determinations, and assists with filing timely appeals.

Responsibilities

• Coordinates, initiates, monitors, and responds to all audit requests/demands. 
• Initiates and monitors the appeal processes in a timely manner.
• Coordinates with facility subject matter experts when necessary. 
• Uses data or maintains a database to track information including but not limited to trends regarding billing practice both within and outside of the hospital. 
• Manages internal and external billing audit communications for all audit-related correspondence.
• Continuously evaluates and improves processes in preparation for audit requests and in response to audit findings.
• Assists interdisciplinary teams in identifying and prioritizing areas of process improvement and develop/implement processes and tools to mitigate risk. 
• Other duties as assigned by the Director.

Qualifications

This is a senior-level position requiring either a Bachelor's degree or at least five years of experience in the healthcare industry. Ideal candidates will have advanced knowledge of healthcare practices, including Medicare reimbursement/payment policies, audit review analysis, medical terminology, and coding.

Key Requirements:

• High level of accuracy and attention to detail
• Ability to work independently and as part of a team
• Strong analytical, investigative, and critical thinking skills
• Ability to analyze business problems and opportunities, providing practical, effective solutions
• Focus on continuous improvement and innovation
• Excellent verbal and written communication skills, with the ability to concisely present findings and recommendations
• Experience collaborating with cross-functional teams to resolve issues using innovative solutions
• Strong negotiation skills