Chargemaster Auditor, Full Time, First Shift

UC Health•Cincinnati, OH

17h

About The Position

The Charge Master Auditor executes charge-related audits and helps evaluate compliance-related services to resolve charging discrepancies. The role provides education to clinical departments about charging processes and procedures, with a particular focus on infusion-related edits and education for Infusion Clinical Departments. The auditor also works charge-related errors to reduce unbilled accounts receivable, supports clean claim submissions, and identifies opportunities to improve workflows and minimize errors or denials.

Requirements

High school diploma.
Minimum 1–2 years of equivalent experience.

Nice To Haves

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

Responsibilities

Perform detailed, focused charge audits on inpatient and outpatient accounts, including defense, prebill, and CPT or charge-code line-item audits.
Evaluate whether charged services and procedures are supported by documentation and whether ICD, CPT, and HCPCS codes are appropriate.
Review audit results with management and staff and consider feedback from internal and external customers.
Track, report, and communicate audit findings, including reimbursement and compliance information.
Enter 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 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 sessions, training sessions, and task-force sessions as directed.
Work charge-related errors to reduce accounts receivable on unbilled accounts.
Research and resolve charge-capture issues.
Edit claims, including DNB, Claim Edits, and Stop Bills, within the scope of authority to support timely billing.
Analyze and correct patient claims and accounts to support clean claim submissions and maintain work queues.
Identify workflow improvements to minimize errors or denials, and share and present findings and recommendations.
Provide occasional backup for other auditors or Billing team members.