Audit Coordinator

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Under the direction of the Manager of Hospital Billing, is responsible for a variety of self-directed tasks including receipt, review, tracking and
compilation of documentation supporting third party audits, ensuring appropriate and complete documentation is provided. In addition,
assists with software training, testing and trouble-shooting. Completes follow up, providing timely and complete communication.

Job Description:

Under the direction of the Manager of Hospital Billing, is responsible for a variety of self-directed tasks including receipt, review, tracking and
compilation of documentation supporting third party audits, ensuring appropriate and complete documentation is provided. In addition,
assists with software training, testing and trouble-shooting. Completes follow up, providing timely and complete communication.

Essential Duties & Responsibilities including but not limited to:

 
1.    Assists the manager of audit in planning and evaluating procedures that support the overall goals and objectives of Revenue Cycle.
2.    Provides training and education for audit software and remains available to appropriately field questions as they arise, ensuring proper
utilization of associated products.
3.    Coordinates all assigned audits, leveraging available software for tracking, communication, appeals final outcome. Identifies patterns of
performance and reports to leadership to take action, offering suggestions for re-education and feedback. 
4.    Works with IT security to ensure all security standards are in place prior to information exchange.
5.    Routinely collaborates with physicians, PFS, Coding, and Administrative personnel throughout BILH to formulate appeals, ensuring
proper and appropriate reimbursement.
6.    Coordinates submission and follow up for a variety of 3rd party audits, including, but not limited to Probe audits, RAC, CMS, DRG
Validation, Medical Necessity, etc.   
7.    Assists in the performance of audits/projects to assure compliance with Joint Commission requirements, Department of Public Health
regulations, and HRO standards.
8.    Interacts with Revenue Cycle managers, supervisors, and section leaders to resolve record retrieval issues and other problems.
Interacts with Physicians, Nurses, Administration, Patient Financial Services staff, and third-party payor personnel regarding reimbursement
and documentation issues,
9.    Adheres to Department, Hospital, and Human Resource Policies.
10.    Performs other duties as assigned.

Minimum Qualifications:

Education:
• High School diploma or equivalent

Experience:
• Five years of healthcare experience required
• Previous office experience
• Epic experience desired
Skills, Knowledge & Abilities:
• Knowledge medical terminology, anatomy and physiology
• Knowledge of medical records content and management
• Knowledge of reimbursement policies and healthcare processes
• Experience with Epic preferred
• Demonstrated ability to handle multiple projects simultaneously and independently
Preferred Qualifications & Skills:
• Associate degree or higher preferred in related field
• Experience working in Revenue Cycle preferred
 

 

 

Pay Range:

$20.00 - $26.92

The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.  Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled