Chart Auditor

AHMC Healthcare•Daly City, CA

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 conducts concurrent and retrospective audits, analyzes findings, supports departments in correcting revenue losses and documentation weaknesses, and prepares monthly audit reports. The Chart Auditor also completes assigned business-office and special audits and collects audit fees when required. The position requires professional conduct, patient confidentiality, positive guest and interdepartmental relations, ongoing professional development, and participation in performance improvement activities.

Requirements

High school diploma or equivalent.
Minimum of 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.
Ability to 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 preferred.

Responsibilities

Perform concurrent audits, including 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 has been 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 help nursing and ancillary services identify revenue losses and inadequate documentation.
Assist nursing and ancillary departments in implementing corrective actions to eliminate lost revenue.
Provide revenue departments with ongoing feedback regarding audit findings.
Prepare a preliminary monthly audit report covering concurrent and retrospective findings, monthly totals of overcharges and undercharges, problem areas, and proposed solutions.
Perform additional duties in other department areas as needed or as determined by management.
Follow established hospital and department policies, maintain patient confidentiality, and complete assigned work within the shift.
Participate in staff meetings and group projects, communicate workplace problems to the supervisor, request assistance as appropriate, and contribute constructively to the team.
Maintain professional and positive interactions with patients, families, medical staff, visitors, and coworkers, including appropriate telephone protocol.
Complete annual safety updates and general and departmental orientation within established time frames; attend in-service programs and maintain applicable licensure or certification.
Identify errors, inefficiencies, and inaccuracies and bring them to management with suggestions for improvement.
Develop solutions to departmental problems, identify and implement cost-control or revenue-generating methods, maximize operational efficiency, and measure progress against quality goals.
Demonstrate cultural responsiveness, including flexibility, empathy, respect, and awareness of communication needs.