ECU Health · 1 day ago
Revenue Integrity Auditor - Professional Billing (PB)
United States
Full-time
Remote
Mid Level
3+ years expECU Health is a mission-driven academic health care system serving over 1.4 million people in eastern North Carolina. They are seeking a Revenue Integrity Auditor to perform charge capture reconciliation audits, report findings, assist in corrective action plans, and maintain compliance with billing regulations.
Hospital & Health Care
Responsibilities
Ensure compliance of the ECU Health Charge Capture Reconciliation Policy is upheld by each revenue generating department across the system
Lead, develop and facilitate a robust audit program that continuously monitors the usage of charge reconciliation reports and charge review work queues
Maintain facility specific scorecards to include corrective action plans for non-compliant departments as well as recognition of departments and individuals who are meeting or exceeding their reconciliation and work queue expectations
Escalate non-compliant departments to designated Leadership and work with appointed individuals to ensure corrective action plans and/or training are being administered and improvement in compliance rates have been achieved
Work with Revenue Integrity leadership to conduct a monthly Revenue Integrity Audit Scorecard Read-Out to each facility's leadership
Share monthly audit results and corrective action plans with finance and clinical leadership
Remain up-to-date on Third Party Billing Regulations by reviewing regulatory/contractual updates and communications. Must be able to utilize this information in the decision making process of implementing accurate and compliant charge capture. Charges that are not accurate or compliant can cause billing errors and result in a payback or in the cases of investigative audits by the OIG or other agencies, financial damages
Answer all questions regarding the appropriateness of charging for services and products. Must be able to function independently. Communication on charging issues must be provided in a professional and customer service oriented manner
Keep up-to-date on EPIC or other related EAP software functionality. Should be able understand the hospital billing system processes and related clinical systems so charges are correctly updated in all systems. Must be able to use Excel or other necessary software to manipulate, summarize, and analyze data
Qualification
Required
3 - 4 years of experience required
Demonstrated ability to manage, teach, make independent decisions and assume responsibility
Strong interpersonal communication skills, verbal and written
Ability to communicate and work effectively with all levels of staff
Working knowledge and experience with PC-based applications, i.e. Word, Excel, PowerPoint, Outlook
Ability to function as a leader, team member and execute the desired outcomes
Must exhibit creative, positive problem-solving abilities
Ability to foster collaboration between multiple parties
Ability to plan, organize and effectively present ideas and concepts to groups
Ability to think conceptually and apply concepts in a practical application
Ability to assimilate information from a variety of sources, analyze information, and determines a course of action
Ability to consider diverse opinions and incorporate them into the decision-making process
Commitment to a high standard of customer service
Preferred
Bachelor's Degree preferred
RHIA/RHIT certification preferred
Hospital Billing Charging and/or Coding Experience is preferred
Benefits
Great Benefits
Company
ECU Health
We come to work every day in order to help you and the 1.4 million people like you across eastern North Carolina.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Brian Floyd
President and COO
Betsey Kirisits, PHR
HR Business Partner II
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