Revenue Cycle Auditor

CSI Companies

1d•$32 - $34•Remote

About The Position

At CSI Pharmacy (CSI), we are on a mission to provide Specialty Pharmacy services to patients with chronic and rare illnesses in need of complex care. CSI is a rapidly growing national Specialty Pharmacy. Whether you work directly with patients or behind the scenes in support of the business and its employees, you will use your expertise, experience, and skills to support our patients and our mission. Summary The Revenue Cycle Auditor is responsible for verifying that revenue cycle practices for the specialty pharmacy are in line with all payers, state and federal compliance guidelines. The Auditor will review, analyze, authenticate, and confirm billing accuracy and collection competency. Research and investigate any missing, inaccurate, or conflicting information. Establish and enforce regular audit schedules. Hourly Range: $32/hr - $34/hr (DOE) Schedule: (Remote) Ideally 8:30am - 5:00pm in your respective time zone; however, the hours are flexible Travel: Optional travel 3xs/year to Plano, TX where the team gets together for in-person collaboration but is not mandatory

Requirements

Previous auditing experience.
Strong communication, interpersonal, and presentation skills, working with both internal and external individuals and entities
Strong ability to self-motivate.
Excellent analytical problem-solving skills.
Strong computer skills with proficiency in Microsoft Office
Maintains discretion and safeguards confidential information
Ability to work effectively with colleagues as team members and to communicate effectively.
Excellent verbal and written communication skills.
Strong customer service orientation.
3--5 years' experience in auditing Home Infusion and/or Specialty Pharmacy billing and collection requirements as they align with all federal, state, and commercial payer guidelines.
Proficient with home infusion specialty pharmacy revenue cycle billing and collection best practices.

Nice To Haves

Experience with CPR+ and/or CareTend preferred but not required.

Responsibilities

Evaluates areas of risk to be addressed by each audit.
Interprets the relative significance of issues needing resolution; escalates at an appropriate time.
Conduct scheduled and non-scheduled compliance audits according to the audit plan while testing compliance with appropriate federal, state, and local regulations and standards, and internal policies and procedures.
Performs risk assessments to identify compliance and non-compliance concerns.
Implements on-going compliance audits by creating and enhancing audit tools relating to audit/monitoring activities and/or researching and investigating issues
Prepare audit reports based on audit findings.
Participates in management meetings to review audit findings and communication areas of concern or risk.
Reviews management responses to determine if recommendations have been satisfactorily addressed.
Addresses responses requiring further clarification or support.
Develops and maintains current knowledge of laws, regulations, and market changes that impact all aspects of the Company, including, but not limited to, Contractual obligations, Federal and State compliance regulations.
Establish and enforce regular audit schedules.
Utilizes the 5 C’s of audits: criteria, condition, cause, consequence, and corrective action
Comply with the Company’s Core Values and Core Competencies
Perform other duties as assigned by supervisor