What are the responsibilities and job description for the Revenue Cycle Auditor position at Memorial Regional Health?
ESSENTIAL FUNCTIONS AND BASIC DUTIES:
Supervisory-Specific Performance Expectations, Duties, and Responsibilities:
- N/A
Position-Specific Performance Expectations, Duties, and Responsibilities:
- Conduct thorough audits of registration, billing, and coding processes to ensure accuracy and compliance
with hospital policies, payer requirements, and regulatory standards
- Analyze revenue cycle data to identify discrepancies, trends, and areas of improvement.
- Ensure compliance with healthcare regulations, including HIPPA, CMS guidelines, and other relevant laws and standards.
- Stay updated on changes in healthcare regulations and payer requirements that impact the revenue cycle.
- Prepare frequent detailed audit reports, including findings, recommendations, and corrective action plans.
- Document and communicate audit results to relevant stakeholders, including department heads and senior management.
- Collaborate with departments such as Registration, Billing, Coding, and Finance to develop and implement process improvements.
- Identify opportunities to optimize revenue capture and minimize revenue leakage.
- Conduct audits on current denials to determine root causes and identify patterns or trends.
- Work with departments to ensure accurate charge capture and coding practices.
- Positive and supportive team member to staff members and the Hospital.
- Interaction with other departments in solving problems and working as a team.
- Demonstrates a professional, positive and caring attitude.
- Performs other duties as assigned.
Organization-Specific Performance Expectations, Duties, and Responsibilities:
- Demonstrates 100% commitment to performance in accordance with the CHOICE values of MRH and representing the organization in a positive and professional manner.
- Establishes and maintains effective verbal and written communication and good working relationships with all patients, staff, and vendors.
- Adheres to MRH attire/dress code per policies and procedures.
- Utilizes initiative; strives to maintain a steady level of productivity; self-motivated; and manages activity and time.
- Completes annual education, training, in-service, and licensure/certification requirements; and attends departmental and organizational staff meetings or reads meeting minutes.
- Maintains patient confidentiality at all times.
- Reports to work on time as scheduled; completes work within designated timeframes.
- Actively participates in departmental and organizational performance improvement and continuous quality improvement activities.
- Strives to uphold regulatory requirements to ensure continual compliance with departmental, hospital, state, and federal regulations and policies.
- Follows policies and procedures for infection control, safety, and risk management to ensure a safe environment for patients, the public, and staff.
QUALIFICATIONS:
Minimum Requirements:
- Must be at least 16 years of age (21 for driving positions with a valid driver’s license).
- Must be able to legally work in the United States.
- Must be able to pass a background check.
- Must be able to pass a drug screen and breath alcohol test (if applicable).
- Must complete employee health meeting.
- Excellent analytical, organizational, and communication skills.
- Extensive knowledge in CAH and RHC billing and coding practices.
Required Education/Licensure/Certification:
- Bachelor’s Degree in Healthcare Administration, Finance, Accounting, or a related field required.
- Minimum of 5 years of experience in healthcare revenue cycle auditing, billing, coding, or related field required.
- Proficiency in Microsoft Excel required.
- Prior Revenue Cycle experience in a Critical Access Hospital and Rural Health Clinic.
Experience:
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification preferred.
- Proficiency in EPIC preferred.
Position Classification: Exempt
Compensation Range: $83,167 to $126,015
Benefits: Medical, Dental, Life, Retirement, Paid Time Off
Salary : $83,167 - $126,015
