Audit Compliance Specialist

BJC HealthCare • St. Louis, MO

5d • Remote

About The Position

This role is responsible for managing pay audit requests from managed care organizations, Medicare, Medicaid, and VA to ensure accurate payments and identify potential overpayment's. Ideal candidates will have some coding knowledge or revenue cycle/billing background to analyze payment details and procedure types, distinguishing between valid and invalid charges. Remote position, must reside in the Greater St. Louis or Kansas City areas.

Requirements

• Associate's Degree
• 2-5 years of experience
• Must reside in the Greater St. Louis or Kansas City areas.

Nice To Haves

• Coding knowledge or revenue cycle/billing background
• RN
• CCS, RHIA, or RHIT

Responsibilities

• Perform insurance billing and process audits and assists with special projects.
• Serve as a regulatory consultant and resource to management and departments at all levels and assist in developing appropriate action plans.
• Performs detailed compliance, process and insurance billing audits in the hospital and outpatient facilities.
• Prepares audit work papers to document billing exceptions or patient care documentation issues.
• Identifies problems or critical issues in billing and patient care documentation.
• Assists with the identification of problems, analysis of problems and development of solutions.
• Assists in the preparation of formal written reports which detail audit findings and recommendations.

Benefits

• Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
• Disability insurance paid for by BJC
• Annual 4% BJC Automatic Retirement Contribution
• 401(k) plan with BJC match
• Tuition Assistance available on first day
• BJC Institute for Learning and Development
• Health Care and Dependent Care Flexible Spending Accounts
• Paid Time Off benefit combines vacation, sick days, holidays and personal time
• Adoption assistance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree