Medical Billing Auditor

2 months ago


Granite City, Illinois, United States Gateway Regional Medical Center Full time
Job Summary

We are seeking a highly skilled Revenue Integrity Specialist to join our team at Gateway Regional Medical Center. As a key member of our revenue cycle team, you will play a critical role in ensuring the accuracy and compliance of our billing processes.

Key Responsibilities
  • Charge Capture
    • Review observation patient records daily and enter observation hour charges, carving out the hours when patients are not actively in the patient room receiving observation services.
    • Review daily revenue and usage reports by department to validate charges are dropping as expected, Urgent Care, Emergency Department, Inpatient, etc.
    • Ensure all documents requiring Provider signatures are complete.
  • Revenue Integrity
    • Act as Hospital representative for internal and external third-party defense audits.
    • Responsible for data input of late charges and credits as determined by audit findings to the Patient Accounting system to reflect audit results.
  • Process Improvement
    • Review and evaluate documentation practices and procedures and make recommendations for improved efficiency and accuracy.
    • Conduct in-depth special studies as requested, sometimes working closely with department directors.
    • Develop and maintain systems for recording audit activities, outcomes, and financial impact of findings.
Requirements
  • Minimum 2-years experience working with clinical staff and documentation in an acute care setting.
  • Knowledge of healthcare industry accepted billing and audit practices.
  • Knowledge of the Charge Description Master and how it relates to accurate billing processes.
  • Knowledge of common procedural coding and medical terminology.
What We Offer
  • Essential and stable company with many opportunities for training and advancement within the medical field.
  • Competitive market pay and opportunities for bonus depending on great work performance.
  • Comprehensive Employee Benefits: Full-Time employees are eligible for various plans for medical, dental, and vision insurance.


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