Audit Denial Specialist
About The Position
Assists in areas of denials and charge errors for review and reconciliation for the Southern Region Hospitals. Responsible for assisting the coordinator in the tracking of CMS Medicare RAC audits and all other third-party payer audits in Comply Track which includes data entry of patient account detail, assignment of jobs to HIM and UM and tracking of assignments for each department to ensure timely submission of all audit requirements. Assists the coordinator in rebilling and adjustment projects identified by the Manager and/or Director, or upon audit results from the Compliance Committee requiring further review. Assists the hospitals with denial reports and support.
Requirements
- Demonstrated knowledge in charging procedures for all departments
- Demonstrated knowledge in billing compliance for federal, state and all third-party payers
- A willingness to learn and pursue excellence is necessary
- Minimum of 3 years recent medical billing experience within a medical organization, hospital or billing company
- 2 to 3 years of hospital computer billing systems experience
- Experience in audit tracking software
- Understanding of denial management systems
- Excellent public/patient relations and communication skills
- Skills in using computers including Excel and Word required
- Skills in using web-based financial applications
- Associates Degree preferred of 5 years work related experience required
Nice To Haves
- Familiarity with all hospital insurance billing
- Familiarity with all forms including payer claims by paper and electronic media is preferred
Responsibilities
- Assists in areas of denials and charge errors for review and reconciliation
- Assists in tracking audits in Comply Track
- Data entry of patient account detail
- Assignment of jobs to HIM and UM
- Tracking of assignments for each department
- Assists in rebilling and adjustment projects
- Assists the hospitals with denial reports and support
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What This Job Offers
Job Type
Part-time
Career Level
Mid Level
Education Level
Associate degree
