Chart Auditor
About The Position
The Chart Auditor is responsible and accountable for auditing charges for patient services and maintaining compliance at Seton Medical Center and Medical Center Coastside. The role performs concurrent, insurance and other retrospective, business-office, and special audits; analyzes audit findings; supports departments in correcting revenue and documentation issues; and prepares a preliminary monthly audit report. The position also requires professional conduct, effective guest and interdepartmental relations, participation in professional development and performance improvement, and cultural competency.
Requirements
- High school diploma or equivalent; a bachelor's degree is preferred.
- At least two years of healthcare experience.
- Understanding of CPT.
- Strong computer skills, including Microsoft programs.
- Strong analytical skills.
- Strong written and oral communication skills.
- Solid problem-solving abilities.
- Ability to work independently with moderate supervision.
- Ability to follow instructions well and produce quality work in a timely manner.
- Knowledge of CMS regulations regarding patient charging.
Nice To Haves
- Bachelor's degree preferred.
- Billing experience preferred.
- CCS certification preferred.
Responsibilities
- Perform concurrent audits, with at least 10 acute reviews, 2 SNF reviews, and 2 subacute reviews; inpatient and outpatient reviews should equal one-third of a single day's revenue.
- Represent the hospital in insurance-requested retrospective audits when a concurrent audit was performed, in addition to other retrospective audits.
- Perform retrospective audits.
- Collect audit fees when required.
- Perform audits requested by the Business Office, as assigned by the Business Office Director.
- Perform special audits as assigned by the CFO or Controller.
- Analyze audit findings and assist nursing and ancillary services in identifying weaknesses that result in lost revenue or inadequate documentation.
- Assist nursing and ancillary departments in implementing corrective actions to eliminate lost revenue, and provide continuous feedback to revenue departments about audit findings.
- Prepare a preliminary monthly audit report covering concurrent and retrospective audit findings, monthly totals of overcharges and undercharges, problem areas, and proposed solutions.
- Perform additional duties in other areas of the department as needed or directed by management.
- Follow hospital and department policies, maintain patient confidentiality, communicate issues and request assistance as appropriate, and complete assigned work within the shift.
- Participate in group projects and staff meetings, contribute constructively to the team, and maintain professional interactions with patients, families, medical staff, visitors, and coworkers.
- Complete annual safety updates and required orientation, attend in-service programs, and maintain licensure or certification as appropriate.
- Identify errors, inefficiencies, and inaccuracies; suggest and implement improvements and cost-control or revenue-generating methods; and support departmental quality and efficiency goals.
- Demonstrate cultural responsiveness, including flexibility, empathy, respect, and awareness of communication needs.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
