Rev Cycle Internal Auditor

Albany Medical Center • Albany, NY

5d

About The Position

The Senior Revenue Cycle Auditor will be a key contributor within the Compliance and Audit department, leading and supporting audit and compliance initiatives. This role will encompass project management, research and analytical tasks while also collaborating across internal and external teams, IT and business operations to ensure and enhance the integrity of revenue cycle processes. The successful candidate will plan, coordinate and manage project activities to ensure goals and objectives are accomplished within prescribed timeframes and budget parameters and that results are proactively communicated to business stakeholders. This individual will also analyze clinical and financial data to find discrepancies and work with various teams to improve the revenue cycle, resolve billing issues, and ensure proper reimbursement for healthcare services. This role will also be responsible for following up on corrective action measures related to outcomes of project activities.

Requirements

• Education: Minimum Bachelor’s degree required
• Licensure, Certification & Registration: Certified Professional Coder (CPC) designation or other Coding Professional Certifications required
• Experience: 4+ years’ experience within the healthcare industry and coding experience required
• Skills, Knowledge & Abilities: In-depth knowledge of hospital revenue cycle and understanding of the Charge Description Master (CDM), charge errors, and charge reconciliation process; EPIC experience a plus
• Strong verbal and written communication skills to effectively teach and interact with internal and external parties
• Strong organizational, project management and leadership skills required

Responsibilities

• Plan, coordinate, and manage projects to ensure project initiatives and timelines are met, working with outsourced teams to develop and define project scope and initiatives
• Collaborate with and communicate project initiatives with business stakeholders to facilitate active engagement and timely response to requests
• Prepare, present, and distribute project status reports to stakeholders
• Apply understanding of regulations and System billing process to assist in evaluating whether procedures and services are properly ordered and billed
• Review and evaluate audit results to determine risk exposure, impact to revenue cycle, identify clinical documentation improvement opportunities, and make recommendations for areas of continued audit focus
• Identify trends based upon audit results and provide recommendations for education, training and corrective actions to internal stakeholders, as needed
• Monitor and follow-up on corrective action plans to determine additional training needs to achieve an environment of sustainable performance
• Ensure availability of performance measurement data for review and analysis; evaluate and drive risk management process improvements, efficiencies and workflow enhancements
• Evaluate the environment of sustainable performance of the Revenue Cycle Operations and provide observations and recommendations for improvements
• Maintains knowledge of new/existing government regulations and third-party payor requirements with regard to documentation, coding and billing requirements.
• Maintain professional credentials through continuing education as required by national and state accreditation organizations
• Ability to work independently, use varying resources to conduct research over subject matter topics, identify opportunities for improvement and provide solutions, and coordinate multiple projects simultaneously
• Ability to communicate effectively across various cross-functional departments
• Represent Albany Med Health System in a professional manner at all times and in all interactions
• Perform all other duties as assigned

Benefits

• Excellent health care coverage with no copay at Albany Medical Center providers
• A wide array of services and programs to support emotional, physical, and mental wellbeing

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level