Performs audit engagements to ARH facilities for the purpose of reviewing, assessing the billing, coding, and documentation practices and to identify areas of risk.
Provides educational in-services tailored to address identified areas of risk in billing and documentation.
Reviews the medical records of Medicare patients, specifically, to insure the accuracy of the physician’s assignment of principal diagnosis, complications, co-morbidity’s, and procedures (documentation) that impact hospital reimbursement. Reviews other payer classes as required
Audits the accuracy of charges.
Prepares written reports to communicate audit findings and recommendations and participates in the exit conference.
Keeps abreast of any new developments and changes in OIG,Federal and State regulations as they relate to billing, coding and compliance issues.
May assist in other auditing functions and perform other related duties as assigned.
Identifies and Trends non-compliance issues within the organization for improvement.
Trends denials and unbilled for resolution.
High School Diploma or GED Equivalent
Must be computer literate in Word and Excel.
Past experience in dealing with public is desired.
Business or Coding Education or Experience
One year experience in an office or one year business school education desired.