Revenue Optimization Auditor (Remote)

Melville,NY - USA

• Position Requirements
• RESPONSIBILITIES
• Audit medical records to identify missed charges, incorrect coding, and other inconsistencies that result in missed billing opportunities.
• Perform Root Cause Analyses and report findings that identify common issues, including over-coding, under-coding and missed billing opportunities.
• Retrieves any missing patient information and documentation required for billing.
• Complete coding of unbilled records identified through audits.
• Prepare reports, executive summaries, and examples of audit findings for presentation and educational purposes.
• Assist with Clinical Documentation recommendation, coding guidance research, and the development of coding educational documents
• Conduct ad-hoc audits as needed to provide root cause analysis and recommendations for resolution.
• Pre-payment audit : review billing vs documentation, send documentation to the payer, complete necessary charge corrections, and / or identify CDI (Clinical Documentation Improvement) opportunities
• Provide resolution of missing documentation tasks. Retrieve or request necessary documents, code for billing, and data entry.
• Provide coding support to cross-functional team inquiries and special projects.
• REQUIRED QUALIFICATIONS
• Minimum 3 years coding experience.
• Must have and maintain an approved coding credential through AAPC (American Academy of Professional Coders) or AHIMA
• Must have or obtain at least one additional certification (CANPC or CPMA), within 1 year of employment.
• Extensive knowledge of medical billing software and electronic medical records.
• Well-rounded knowledge of CMS requirements claims processing, billing / coding guidelines, and the Revenue Cycle process.
• Proficient PC skills, including Microsoft 365.
• Excel Proficiency to include basic formulas, concatenate, VLOOKUP, and pivot tables).
• PREFERRED QUALIFICATIONS
• Previous coding experience within Anesthesia or General Surgery.
• Clinical Documentation compliance and regulatory requirements.
• TOTAL REWARDS :
• Salary : $60,000- $82,500 annually
• Generous benefits package, including :
• Paid Time Off
• Health, life, vision, dental, disability, and AD&D insurance
• Flexible Spending Accounts / Health Savings Accounts
• 401(k)
• Leadership and professional development opportunitiesThe Auditor, Revenue Optimization is responsible for conducting audits and reviewing clinical documentation to ensure proper charge capture, billing in accordance with standard billing policies and compliance standards. This individual is responsible for assisting the team with resolution of coding / billing issues, participating in external / internal audit requests, payer audits, and special projects as needed.
• EEO Statement
• North American Partners in Anesthesia is an equal opportunity employer.North American Partners in Anesthesia (NAPA) has evolved through more than 30 years to become a leader in anesthesia and perioperative services. Single specialty and clinician led, we remain committed to our mission of delivering exceptional patient experiences, every day. At NAPA, we cultivate leaders, promote work-life balance, and celebrate diversity. We know your success promotes our success, and we give you the tools and programs to achieve your goals. With flexibility, a collegial and collaborative environment, a wide range of market-leading benefits, and career opportunities from coast-to-coast, your future is waiting at NAPA.

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