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Revenue Optimization Auditor (Remote)

Role overview

Qualifications

  • Minimum 3 years coding experience
  • Must have and maintain an approved coding credential through AAPC or AHIMA
  • Must have or obtain at least one additional certification (CANPC or CPMA) within 1 year of employment
  • Extensive knowledge of medical billing software and electronic medical records

Responsibilities

  • Audit medical records to identify missed charges, incorrect coding, and other inconsistencies
  • Perform Root Cause Analyses and report findings on common issues
  • Retrieve any missing patient information and documentation required for billing
  • Prepare reports, executive summaries, and examples of audit findings for presentation

Key facts

Hard skills

Other skills

  • Microsoft Excel
  • Detail Oriented
  • Problem Solving
  • Communication
  • Teamwork

About the company

North American Partners in Anesthesia logo

North American Partners in Anesthesia

Medical Practices & Clinics

As a clinician-led organization, North American Partners in Anesthesia (NAPA) is redefining healthcare, delivering unsurpassed excellence to its partners and patients every day. Since its founding by physicians in 1986, NAPA has grown to become one of the nation’s leading single-specialty anesthesia and perioperative management companies, serving more than 3 million patients annually in more than 500 healthcare facilities nationwide. Our highly skilled teams of clinicians participate in groundbreaking leadership development and customer service training programs to deliver optimal results to patients, surgeons, healthcare administrators, and staff. Through our exceptional perioperative leadership, research, innovations, and state-of-the-art technologies, NAPA offers real solutions driven by evidence-based outcomes to dramatically accelerate operational efficiencies, increase satisfaction ratings, and enhance safety and profitability.

Company details

Company typeXLarge
IndustryMedical Practices & Clinics
Company size5001 - 10000

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Job description

Sunrise,FL - USA

Position Requirements

RESPONSIBILITIES

  • Audit medical records to identify missed charges, incorrect coding, and other inconsistencies that result in missed billing opportunities.
  • Perform Root Cause Analyses and report findings that identify common issues, including over-coding, under-coding and missed billing opportunities.
  • Retrieves any missing patient information and documentation required for billing.
  • Complete coding of unbilled records identified through audits.
  • Prepare reports, executive summaries, and examples of audit findings for presentation and educational purposes.
  • Assist with Clinical Documentation recommendation, coding guidance research, and the development of coding educational documents
  • Conduct ad-hoc audits as needed to provide root cause analysis and recommendations for resolution.
  • Pre-payment audit: review billing vs documentation, send documentation to the payer, complete necessary charge corrections, and/or identify CDI (Clinical Documentation Improvement) opportunities
  • Provide resolution of missing documentation tasks. Retrieve or request necessary documents, code for billing, and data entry.
  • Provide coding support to cross-functional team inquiries and special projects.

REQUIRED QUALIFICATIONS

  • Minimum 3 years coding experience.
  • Must have and maintain an approved coding credential through AAPC (American Academy of Professional Coders) or AHIMA
  • Must have or obtain at least one additional certification (CANPC or CPMA), within 1 year of employment.
  • Extensive knowledge of medical billing software and electronic medical records.
  • Well-rounded knowledge of CMS requirements claims processing, billing/coding guidelines, and the Revenue Cycle process.
  • Proficient PC skills, including Microsoft 365.
  • Excel Proficiency to include basic formulas, concatenate, VLOOKUP, and pivot tables).
     

PREFERRED QUALIFICATIONS

  • Previous coding experience within Anesthesia or General Surgery.
  • Clinical Documentation compliance and regulatory requirements.

Total Rewards:

  • Salary: $58,000 - $78,000 annually
  • Generous benefits package, including:
    • Paid Time Off
    • Health, life, vision, dental, disability, and AD&D insurance
    • Flexible Spending Accounts/Health Savings Accounts
    • 401(k)
    • Leadership and professional development opportunities
The Auditor, Revenue Optimization is responsible for conducting audits and reviewing clinical documentation to ensure proper charge capture, billing in accordance with standard billing policies and compliance standards. This individual is responsible for assisting the team with resolution of coding/ billing issues, participating in external/internal audit requests, payer audits, and special projects as needed.

EEO Statement

North American Partners in Anesthesia is an equal opportunity employer.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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