Audit Coordinator
Audit Coordinator
Posted on :
09-04-2025
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1 Vacancy
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Monthly Salary
Not Disclosed
Salary Not Disclosed
Vacancy
1 Vacancy
Posted on :
09-04-2025
Job Description
EXPERIENCE/TRAINING:
The Audit Coordinator should have knowledge experience and expertise in the following areas:
Minimum of 2 years of billing audit experience
Format and content of a medical record and various forms of medical/clinical documentation
Medical Terminology and coding including CPT and HCPCs
State and Federal Regulations concerning the use disclosure and confidentiality of patient records
Auditing principles and standards as applicable to charge audits
Billing and charge capture procedures and claim forms.
Excellent oral and written communication skills.
Effective negotiating skills including the ability to resolve cited charge issues by extracting supportive documentation for dispute resolution/appeals purposes are required.
Team and service oriented.
Ability to interact with all levels of health care personnel and hospital/finance management and build strong working relationships with internal and external customers.
Strong organizational and time management skills.
Ability to work independently in a role that requires flexibility in an environment that is deadline driven.
Ability to identify root cause of issues uncovered in the charge audit process and gather organize and present issues to appropriate areas with recommendations for corrective actions.
Experience with computer software programs such as Word and Excel are required.
Ability to function as a department subject matter expert and resource with a focus on contributing to the achievement of departmental and corporate goals.
About Us:
As a notforprofit organization Partners HealthCare is committed to supporting patient care research teaching and service to the community by leading innovation across our system. Founded by Brigham and Womens Hospital and Massachusetts General Hospital Partners HealthCare supports a complete continuum of care including community and specialty hospitals a managed care organization a physician network community health centers home care and other healthrelated entities. Several of our hospitals are teaching affiliates of Harvard Medical School and our system is a national leader in biomedical research.
Were focused on a peoplefirst culture for our systems patients and our professional family. Thats why we provide our employees with more ways to achieve their potential. Partners HealthCare is committed to aligning our employees personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal developmentand we recognize success at every step.
Our employees use the Partners HealthCare values to govern decisions actions and behaviors. These values guide how we get our work done: Patients Affordability Accountability & Service Commitment Decisiveness Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion Integrity & Respect Learning Continuous Improvement & Personal Growth Teamwork & Collaboration.
Reporting to the Audit Manager the Charge Audit Coordinator position is responsible for the coordination and facilitation of all activities pertinent to Charge Audits being conducted at Brigham & Womens Hospital and Massachusetts General Hospital (other entities as assigned) in accordance with the PHS Charge Audit Policy and established departmental policies and procedures.
Duties
1.Coordinates the scheduling of audits with external Payer Audit Representatives/Payers to initiate the onsite charge audit process.
2.Oversees the preparation of detailed packages for cases selected by Payer Audit Representatives including itemized bills and other necessary documents needed to initiate the audit process
3.Ensures timely requests are made to medical records for preparation of third party/charge audits including patient authorizations as defined by the PHS Charge Audit Policies
4.Conducts entrance and exit interviews with Payer Audit Representatives and followup as needed
5.Documents and summarizes findings in a clear concise and effective manner to preserve PHS appeal rights and to assist with improvements in the charge capture process
6.Conducts post audit research to support and defend cited charges by obtaining additional documentation and works directly (via phone fax secure email or in person) with the Payer Audit Representative to arrive at agreed upon audit outcomes in a timely manner.
7.Document the findings and final outcomes of all accounts reviewed by the Payer Audit Representative in the PHS Audit Tracking tool and respective billing system.
8.Communicates areas of identified opportunities for revenue improvement to Revenue Integrity Management team. Opportunities can include results from under billed and/or unbilled services/items based on supporting documentation in the medical record when compared to itemized billed charges or list of active charge codes for a given cost center.
9.Identifies ongoing issues with charging and documentation for discussion with Revenue Integrity Staff and prospectively the revenue generating departments to recommend corrective actions to prevent future losses.
10.Maintains internal systems used for tracking and reporting of findings including but not limited to PHS Audit Tracking System patient accounting systems spreadsheets databases to facilitate monthly management reporting
11.Develops and maintains professional working relationships with internal and external stakeholders to facilitate continuous process improvement as it relates to audit activity and findings
EEO:
Partners HealthCare is an Equal Opportunity Employer & by embracing diverse skills perspectives and ideas we choose to lead. All qualified applicants will receive consideration for employment without regard to race color religious creed national origin sex age gender identity disability sexual orientation military service genetic information and/or other status protected under law.
Required Experience:
IC
Employment Type
Full-Time
Key Skills
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