Revenue Cycle Auditor

Are You A Meticulous And

experienced Revenue Cycle Auditor looking to join a dynamic team? LaSalle Network has partnered with a premiere healthcare services company as they look to expand their team. As a Revenue Cycle Auditor, you will be responsible for investigations received from the revenue cycle department and working a yearly audit plan.

Revenue Cycle Auditor

Responsibilities:Conducts comprehensive retrospective and/or prospective coding/billing/documentation audits for multi-specialties within the medical group and/or facility departments, as assignedAnalyzes source documents (including but not limited to, progress notes, operative reports, pathology reports, etc.) and associated billing documentation (such as encounter forms, EOBs, Epic billing data and related documents) for coding and billing accuracy Audits ICD-10-CM, CPT/HCPCS or ICD-10-PCS codes for appropriateness compared to medical record documentation by applying appropriate corporate policy, state/federal regulation, coding rules, commercial payer guidelines, and/or Medicare/Medicaid guidelines (e.g. NCDs, LCDs, Medicare Manuals, and DRG/APC/RBRVS/other relevant Prospective Payment System billing rules)Conducts internal Compliance investigations in response to external concerns. These investigations can involve high-risk scenarios that require immediate and extensive review while maintaining a strict level of confidentialityIdentifies trends or patterns of questionable coding and billing practices for the System and reports issues to Manager. Communicates incidental findings identified in audits for potential future investigationDocuments relevant findings for all audits and investigations conducted, including pertinent details from interviews, claim audits, control assessment, root cause analysis and corrective action plansCalculates reimbursement impact and statistical error rates based on findings in audits and investigations that may later result in larger overpayment calculations. Overpayment calculations may sometimes require data mining and testing

skills to ensure report accuracy and using extrapolation methodologiesFacilitates communication of audit and investigational activities between internal/external customersKeeps current on topics related to coding, billing, and documentation

requirements, including, but not limited to ICD-10-CM/PCS and CPT/HCPCS annual code changes and Medicare regulatory

Revenue Cycle Auditor

Requirements

Experience with analyzing and/or auditing Revenue Cycle functions; including, but not limited to, ICD-10, CPT, and HCPCS coding accuracy, Medicare policy

requirements and any other operational workflows affecting billing accuracy for hospital or physician claimsSkilled at medical coding and related research and analysis with the ability to stay up to date on regulatory and coding changes and applying those rule changes into audit and investigation projectsMust have the ability to interpret a variety of clinical documents and information, CMS policies and procedures, third party payer guidelines and government regulations and effectively communicate technical coding information to a variety of non-coder staff

If you are interested in this exciting Revenue Cycle Auditor opportunity and feel you meet these

qualifications, please apply today!

Thank you,

Laura Peterson

Associate Unit Manager - Healthcare Revenue Cycle

Lasalle Network Lasalle Network Is An

Equal Opportunity Employer m/f/d/v. LaSalle Network is the leading provider of direct hire and temporary staffing services. For over two decades, LaSalle has helped organizations hire faster and connect top talent with opportunities, from entry-level positions to the C-suite. With units specializing in Accounting and Finance, Administrative, Marketing, Technology, Supply chain, Healthcare Revenue Cycle, Call Center, Human Resources and Executive Search. LaSalle offers staffing and recruiting solutions to companies of all sizes and across all industries. LaSalle Network is the premier staffing and recruiting firm, earning over 100 culture, revenue and industry-based awards from major publications and having its company experts regularly contribute insights on retention strategies, hiring trends and hiring challenges, and more to national news outlets.