Remote Revenue Integrity Auditor
Remote Revenue Integrity Auditor
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Job Description
City/State
Norfolk VAWork Shift
First (Days)Overview:
The Revenue Integrity Auditor will perform detailed audits of the medical record at Sentara facilities by researching and analyzing the accuracy of the medical record documentation to the itemized bill to ensure charges are defensible under scrutiny with our payers. The Revenue Integrity Auditor ensures adherence to regulatory requirements related to billing and supporting documentation as well as facilitates the completion of appeals in a timely manner. This position identifies and works collaboratively to correct discrepancies in patient charges and can participate in engagements involving payer contracts regulatory compliance revenue integrity and operational assessments. This position is responsible for the coordination of external reviews / audits including but not limited to Medicare Medicaid or Commercial payers; pre and/or post documentation commercial insurance medical records request/reviews
Key Responsibilities
This includes but is not limited to establishing workflows policies and procedures software analysis and maintenance and implementation of processes and communication plans for the facilitys interactions with third party auditors including but not limited to pre and post payment Medicare Medicaid and commercial insurances reviews to ensure timely completion or review/audit documentation requests.
This position is responsible for the oversight of all pre and post payment audit functions medical documentation requests and is responsible for maintaining a tracking system for all audits/requests activity throughout all levels of appeals.
Education:
Bachelors degree (Required).
Candidates with a total of 4 years of healthcare appeals experience will be considered in lieu of the Bachelors Degree requirement
Experience:
3 years of healthcare appeals experience (Required)
Legal Resources Plan
Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30000-member workforce. Diversity inclusion and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission to improve health every day this is a tobacco-free environment.
For positions that are available as remote work Sentara Health employs associates in the following states:
Alabama Delaware Florida Georgia Idaho Indiana Kansas Louisiana Maine Maryland Minnesota Nebraska Nevada New Hampshire North Carolina North Dakota Ohio Oklahoma Pennsylvania South Carolina South Dakota Tennessee Texas Utah Virginia Washington West Virginia Wisconsin and Wyoming.
Employment Type
Full-Time
