Revenue Cycle Auditor

Hello humankindness Dignity Health Medical Group is the employed physician group of Dignity Health Arizona. Dignity Health Medical Group (DHMG) employs approximately 200 providers and 500 support staff that cover a wide variety of specialties. The medical group has had tremendous success over the past few years and now provides more than 73 subspecialty services. The physicians provide clinical services in their areas of specialty and many serve in pivotal academic research and leadership roles.DHMG is also heavily involved in preparing tomorrows healthcare providers. DHMG has 84 medical school students and approximately 200 residents and fellows throughout the 25 academic programs. Clinical services are complemented with translational and bench research to augment medical education for residents and students. The mission of Dignity Health Medical Group is consistent with Dignity Healths mission and St. Josephs guiding principles with a focus on innovative clinical care and the pursuit of excellence through scholarly activities. As part of the Dignity Health hospital system DHMG has full access to the staff and all facilities on our hospital campuses. This unique relationship with our hospital allows Dignity Health Medical Group to provide its patients with state-of-the-art patient services including care of the poor and disenfranchised.Look for us on Facebook and follow us on Twitter.For the health of our community ... we are proud to announce that we are a tobacco-free campus

Under the supervision of the Business Office Leadership, the Revenue Cycle Auditor role is responsible for monitoring the quality of work performed within the Business Office consistent with the mission and philosophy of CommonSpirit Health.

• Demonstrate a solid understanding of accounts receivable and your role as a Revenue Cycle Auditor: *Payor Rules & Regulations *Understanding contract language *CCI Coding Issues * Comprehend how transactions affect account *Coordination of Benefits rules *Coding knowledge *Offsets / Takebacks *Payment Posting
• Ability to determine correct systems to locate pertinent info: *IDX *Medical Records Systems *Insurance Payor Websites *Code Correct Web Site *Vendor Systems
• Perform comprehensive audits to verify the accuracy of revenue cycle staff actions, including: financial clearance, claim resolution, cash application accuracy, credit research, coding-related claim rejections, and accounts receivable follow-up actions.
• Ability to manage multiple expectations, task and deadlines effectively.
• Timely review of electronic communication to stay informed of changes that affect your position.
• Research and analyze account thoroughly including direct contact with payor to determine if action(s) taken are in compliance with current workflows, guidelines, policies and procedures.
• Proactively organize and manage case load to ensure timely feedback to staff.
• Ability to independently research and resolve complex issues with available resources and tools.
• Maintains tracks and complies audit scores with in expected turn around time.
• Utilizes appropriate chain of command to assist in resolving complex issues after necessary research has been completed.
• Works directly with department supervisors to ensure compliance with billing regulations on all discrepancies identified in the audit.
• Provide timely and organized feedback in regards to audits: *staff development/education *needed recourse *audit results
• Takes initiative to find opportunities for process improvement within the department.

**Must be a Certified Professional Coder (CPC) or Certified Professional Medical Auditor (CPMA)

Dignity Health now offers an Education Benefit program for benefit-eligible employees.  This program provides debt relief and student loan assistance to help you achieve your goals. Full-time employees can receive up to $18,000 over five years, while part-time employees can receive up to $9,000. While you’re busy impacting the healthcare industry, we’ll take care of you with benefits that include health/dental/vision, FSA, matching retirement plans, paid vacation, and adoption assistance.

MINIMUM

• High School Diploma or GED
• 5-7 years experience in professional medical billing office with 3 years in a multi specialty medical group
• Knowledge of physician billing regulations.Understanding of professional claims and billing procedures.
• Knowledge of Federal and State regulations applicable to Government and Insurance Collections.
• Excellent written and verbal communication skills.
• Results oriented attitude, good interpersonal abilities required to deal effectively with job responsibilities.
• Must be able to use a high level of judgment, initiative, and resourcefulness when dealing with internal and external customers.
• Demonstrated ability to work independently.
• Working knowledge of computers and demonstrated proficiency in using Google applications, Internet and Payer websites.Working knowledge of IDX and Cerner.
• Certified Professional Coder (CPC) or Certified Professional Medical Auditor (CPMA)

PREFERRED

• Previous auditing experience.
• Certified Professional Biller.