Chargemaster Auditor, Full Time, First Shift

UC Health•Cincinnati, OH

19h

About The Position

The Chargemaster Auditor executes charge-related audits and helps evaluate compliance-related services to resolve charging discrepancies. The role provides outreach education to clinical departments on charging processes and procedures, with a particular focus on infusion-related edits and education for infusion clinical departments.

Requirements

High school diploma; healthcare experience or education is specified as the minimum requirement.
Minimum of 1–2 years of equivalent experience.

Nice To Haves

Bachelor’s degree preferred.
Professional Medical Auditor (CPMA) or equivalent certification preferred.
3–5 years of equivalent experience preferred.

Responsibilities

Perform detailed, focused charge audits on inpatient and outpatient accounts, including defense, prebill, and CPT/charge-code line-item audits.
Evaluate whether services and procedures charged are supported by documentation and whether ICD, CPT, and HCPCS codes are appropriate.
Review audit results with management and staff, taking customer feedback into account as appropriate.
Track, report, and communicate audit findings, including reimbursement and compliance information, and maintain charge-audit results data.
Present audit findings and help develop constructive recommendations and education for clinical departments.
Partner with Internal Audit on charge-related audits included in its annual audit program.
Develop and provide educational sessions with revenue-producing clinical department managers on issues identified through audits.
Respond to clinical department questions and review cases to support correct charge-capture processes and procedures.
Attend educational, training, and task-force sessions as directed.
Reduce accounts receivable on unbilled accounts by resolving charge-related errors.
Research and resolve charge-capture issues; edit claims, including DNB, Claim Edits, and Stop Bills, within scope of authority to support timely billing.
Analyze and make necessary corrections to patient claims and accounts to support clean claim submissions, and maintain work queues.
Identify workflow improvements to minimize errors and denials, and share and present findings and recommendations.
Provide occasional backup for other auditors or Billing team members.
Perform other duties as assigned.