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

University of Southern California • Los Angeles, CA

14h • 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. Essential Duties: 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.

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.

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) OR Registered Nurse - RN (CA DCA) OR Certified Coding Specialist - CCS (AHIMA) OR Certified Professional Coder - CPC (AAPC)

Responsibilities

• Validating, clearing, and finalizing DNB edits in the PFS host Patient Accounting system or claims editing system.
• Conducting insurance audits with designated payer auditors per contractual terms.
• Communicating with hospital departments regarding disputed charges, charge capture, and pending supporting documentation.
• Interacting with hospital departments, PFS Business Office, and insurance/payers on audits, disputed charges, and billing/charging problems.
• Communicating with hospital department directors on outstanding or missing documentation or charging issues.
• Completing charge audits or billing edits in a timely and accurate manner.
• Assisting with training for new hires or temporary/contract staff.
• Complying with USC University Hospital guidelines.
• Communicating with insurance companies or auditing services to resolve complaints or defense audits.
• Completing department charge master updates and department requests timely and accurately.
• Finding solutions to existing charging problems.
• Scheduling and conducting high dollar amount defense audits of patient medical records with insurance company representatives.
• Completing charge corrections and coordinating necessary re-bills based on agreed audit results.
• Validating and managing bill holds relating to charge reviews held by Risk Management.
• Coordinating approvals with Risk Management and the bill release process.
• Conducting concurrent or focus audits to validate charge capture audits on randomly selected accounts monthly.
• Working DNFB and PFS claim edits work lists to ensure timely completion within Keck USC policies and monthly goals.
• Assisting and supporting the Director of Revenue Analysis and Director of A/R Management as assigned.
• Performing any other duties and responsibilities as assigned.

Benefits

• Annual base salary range: $68,640.00 - $112,370.00
• Consideration of scope and responsibilities of the position, candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations when extending an offer.
• Equal opportunity employer.
• Consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other characteristic protected by law or USC policy.
• Affirmative action obligations consistent with state and federal law.
• Consideration for employment of all qualified applicants with criminal records in a manner consistent with applicable laws and regulations, including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance, and with due consideration for patient and student safety.
• Reasonable accommodations to applicants and employees with disabilities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees