Chart Auditor - Revenue Cycle Operations - Full Time 8 Hour Days (Exempt) (Non-Union)

University of Southern California•Los Angeles, CA

1d•Onsite

About The Position

The Chart Auditor is responsible for validating, clearing, and finalizing DNB edits either in the PFS host Patient Accounting system or claims editing system. At times, the Chart Auditor may conduct insurance audits with designated payer auditor per contractual terms. The Chart Auditor may also be responsible for hospital department communication including disputed charges, charge capture, and or pending supporting documentation. USC is a leading private research university located in the heart of downtown Los Angeles – a global center for arts, technology and international business. As the largest private employer in the city – responsible for more than $5 billion annually in economic activity in the region – we offer the opportunity to work in a dynamic and diverse environment, in careers that span a broad spectrum of talents and skills. As a USC employee, you will enjoy excellent benefits and perks, and you will be a member of the Trojan Family - the faculty, staff, students and alumni who make USC a great place to work.

Requirements

High school or equivalent
Read, write and follow written and verbal instructions.
Working functions of the Medical Record Department.
Good organizational skills and the ability to effectively handle multiple priorities and deadlines.
Operate standard office equipment, for example, scanning equipment, fax machines, multi-line telephone system and copy machines.
Work independently and as a team member.
Maintain confidentiality of sensitive information.
Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)

Nice To Haves

Specialized/technical training Graduate from an accredit program in one of the following areas: LVN, RN, Certified Coding Specialist or Professional Coder.
1 year Experience in medical auditing or HIM coding preferred
Computers and keyboarding skill, PC, Windows, Excel.
Licensed Vocational Nurse - LVN (CA DCA)
Registered Nurse - RN (CA DCA)
Certified Coding Specialist - CCS (AHIMA)
Certified Professional Coder - CPC (AAPC)

Responsibilities

Responsible for interacting with hospital departments including the PFS Business Office, and or insurance/payers on audits, disputed charges and hospital billing and charging problems.
Communicate with hospital department directors on a weekly or as needed basis on outstanding or missing documentation or charging issues.
Completes charge audits or billing edits as necessary in a timely and accurate manner.
Assists with training for new hires or temporary/contract staff.
Complies with USC University Hospital guidelines.
Communicates with , insurance companies or auditing services to resolve complaints or defense audits.
Completes department charge master updates and department requests timely and accurately.
Communicates with hospital departments as needed regarding billing, charging, and documentation problems.
Finds solutions to existing charging problems.
Schedules and conducts high dollar amount defense audits of patient medical records with insurance company representatives to verify documentation to support hospital
Completes charge corrections and coordinates necessary re-bills based on agreed audit results.
Validates and manages bill holds relating to charge reviews held by Risk Management.
Coordinates approvals with Risk Management an d bill release process.
Conduct concurrent or focus audits to validate charge capture audits on randomly selected accounts monthly to identify charging issues which may indicate deficiencies in charge pathways and processes and target specific departmental issues.
Consistently and thoroughly work DNFB and PFS claim edits work lists to ensure timely completion within Keck USC policies and monthly goals.
Assists and supports the Director of Revenue Analysis and Director of A/R Management as assigned.
Performs any other duties and responsibilities as assigned.