Revenue Integrity Auditor

ECU Health Medical Center•Greenville, NC

1d•$56,618 - $82,528•Remote

About The Position

Perform charge capture reconciliation audits for all hospitals within the ECU Health System to ensure compliance with the system’s Departmental Charge Capture and Reconciliation Policy. Report findings through monthly facility-specific Revenue Integrity Audit Scorecards and assist Revenue Integrity Leadership with monthly meetings to discuss audit results. Support departmental leaders in developing corrective action plans and training for non-compliant areas, then re-audit to assess improvement. Maintain expertise in third-party billing regulations and requirements to help ensure Epic EAP/CDM compliance for ECU Health entities. Develop tools and educational communications for revenue-producing departments, analyze reimbursement and charge data for service-line analyses and special projects, and maintain an understanding of systems used to update charges and related PC skills. This is a remote role based out of Greenville, North Carolina, with a Monday–Friday full-time day shift. The listed pay range is $56,617.60–$82,528.16 per year.

Requirements

3–4 years of experience required.
Demonstrated ability to manage, teach, make independent decisions, and assume responsibility.
Strong verbal and written interpersonal communication skills.
Ability to communicate and work effectively with all levels of staff.
Working knowledge and experience with PC-based applications, including Word, Excel, PowerPoint, and Outlook.
Ability to function as a leader and team member and execute desired outcomes.
Creative, positive problem-solving abilities.
Ability to foster collaboration among multiple parties.
Ability to plan, organize, and present ideas and concepts effectively to groups.
Ability to think conceptually and apply concepts in practical settings.
Ability to assimilate and analyze information from varied sources and determine a course of action.
Ability to consider diverse opinions and incorporate them into decision-making.
Commitment to a high standard of customer service.
Ability to function independently when addressing charging questions.

Nice To Haves

Bachelor’s degree preferred.
RHIA or RHIT certification preferred.
Physician billing charging and/or coding experience preferred.

Responsibilities

Ensure each revenue-generating department across the system complies with the ECU Health Charge Capture Reconciliation Policy.
Lead, develop, and facilitate an audit program that monitors use of charge reconciliation reports and charge review work queues.
Maintain facility-specific scorecards, including corrective action plans for non-compliant departments and recognition of departments and individuals meeting or exceeding expectations.
Escalate non-compliant departments to designated leadership and work with appointed individuals to implement corrective action plans or training and improve compliance rates.
Work with Revenue Integrity Leadership to present monthly Revenue Integrity Audit Scorecard read-outs to each facility’s leadership.
Share monthly audit results and corrective action plans with finance and clinical leadership.
Review regulatory and contractual updates to remain current on third-party billing regulations, and apply that knowledge to accurate and compliant charge capture decisions.
Answer questions about the appropriateness of charging for services and products, working independently and communicating professionally with a customer-service focus.
Stay current on Epic or other related EAP software functionality and understand hospital billing and related clinical-system processes so charges are updated correctly.
Use Excel or other necessary software to manipulate, summarize, and analyze data.
Develop tools and educational communications for revenue-producing departments.
Analyze reimbursement and charge data for service-line analysis and other special projects.
Assist departmental leadership with corrective action plans and training, and re-audit non-compliant areas to evaluate improvement.