Auditor (Multi-Specialty)

Location: Remote (travel required)  

SCOPE/GENERAL PURPOSE OF JOB: 

Responsible for coordinating and providing auditing services to clients (i.e., physician groups, billing companies, hospitals, health systems, health care attorneys, and other health care entities) including coding/documentation audits, billing audits, compliance audits, general and targeted educational sessions, expert advice on coding, documentation, and billing topics, operational assessments and other engagements as assigned. 

ESSENTIAL DUTIES AND RESPONSIBILITIES: 

• Coordinates and provides consulting services with clients in accordance with their contractual agreement (onsite and remote)
• Defines expectations and timelines with clients and RCCS management in accordance wit client contracts 
• Review SOW, schedule calls and create any databases needed 
• Performs comprehensive documentation, coding, billing and/or compliance audits in accordance with client contract 
• Create accurate well written reports summarizing audit findings and recommendations which include clear explanation of errors and references for authorization guidance supporting recommendations when applicable. 
• Present audit findings and recommendations in person or by phone.
• Customize training material for client specific needs
• Deliver onsite or remote educational sessions 
• Conducts and participates in webinar training, conference calls, creation of documents and materials for clients
• Other consulting projects as assigned (ex. CDM reviews, workflow assignments, denials management evaluations, etc.)
• Maintains an accurate record of time spent on all assignments (client and non-client work)
• Assist in creating and updating coding reference manuals and presentations as needed
• Communicates with management regarding client concerns, issues or assistance as needed 
• Monitors government regulations & programs and presents information to the company and clients  
• Prepares and conducts information and education speeches for industry organizations
• Attends trade shows for marketing, vendor relations, clients and potential new business opportunities
• Creates, prepares and presents educational reference guides, webinars and conference presentations (CROWN) as required 
• Prepares industry related articles for publication when requested 
• Strives to achieve maximum exposure and strong public image of Revenue Cycle Coding Strategies to all industry stakeholders 
• Works on ensuring a strong, positive relationship between all company divisions 
• Ensures compliance with company Polices & Procedures, State & Federal Regulations 
• Maintains confidentiality of all information related to patients, medical staff, finances and all other company and client information 
• Submits accurate invoices and expense reports timely to the appropriate department following company polices  
• Adheres to all RCCS polices and procedures 
• Additional duties as assigned 

EDUCATION AND/OR EXPERIENCE:

• Bachelor's degree preferred but not required 
• Coding certification(s) required by one or more of the following bodies: AHIMA, RCCB, AAPC. 
• Willingness to obtain additional industry specific certifications within one year of employment 
• SME in multiple areas of expertise within 2 years of moving into role
• Minimum three years of experience as a consultant, auditor/educator, or compliance professional in healthcare

QUALIFICATIONS: 

• Expert level in knowledge of coding, documentation, and reimbursement 
• Knowledge of organization Policies and Procedures 
• Knowledge of healthcare administration principles 
• Knowledge of business office procedures as they related to the healthcare industry 
• Skill in exercising initiative, judgement, discretion and decision making to achieve objectives 
• Skill in identifying and resolving problems 
• Ability to communicate effectively and professionally with all levels of staffing in health care provider organizations and business related organizations 
• Ability to establish and maintain effective professional working relationships with all employees and clients 
• Knowledge of CPT-4, diagnosis and HCPCS coding
• Highly detail oriented with outstanding analytical and writing skills
• Ability to communicate professionally with and clients and employees of RCCS
• Must be competent and comfortable with MS Word, Excel, Outlook and PowerPoint
• Experience working in MS Access is preferred