Compliance Billing Auditor - Anesthesia

Essential Functions:

• Coordinates with Compliance Audit Manager and Sr. Audit Director on any billing compliance investigations.
• Reviews and audits documentation in the medical records and charges submitted including CPT and ICD-10information to ensure compliance.
• Reviews charge information, claim forms, and insurance correspondence to determine if coding, billing, claim follow-up, payment receipts, posting activities, and credit processing are being performed in an accurate and timely manner and is supported by documentation.
• Analyzes billing trends to identify areas of non-compliance and prepares regular reports on audit findings to Compliance Manager.
• Collaborates with the Compliance Team to develop annual audit work plans.
• Educates providers when deficiencies in documentation and code selection are identified.
• Develops corrective action plans and participates in compliance investigations as needed.
• Performs other duties as assigned.

Qualifications:

• CPC certification required
• 1 to 3 years applicable compliance experience preferably in healthcare..
• 4 years of healthcare billing and coding experience preferred.
• Anesthesia billing and coding preferred.
• Excel and Power Point knowledge preferred

Knowledge, Skills, and Abilities:

• Must be a self-starter
• Experience with anesthesia documentation and coding helpful
• Knowledge of auditing procedures and techniques
• Must work independently and with direction
• Advanced knowledge of Microsoft Suite
• Ability to compose memos/letters and other correspondence
• Ability to prepare and write reports, summaries of work/work projects
• Ability to prioritize workload and meet strict deadlines
• Strong organizational skills
• Ability to work in a fast-paced and fluid environment
• Strong problem-solving skills and attention to detail
• Strong personal motivation with ability to work with little supervision and attention to detail while working in a deadline driven environment
• Ability to communicate clearly and concisely across multiple levels within the company
• Works directly with or develops confidential information, which requires regular use of discretion.
• Decisions require moderate analysis of data or information requiring development or application of several alternative methods. May involve the development of timetables or interpretation of data with moderate impact on an employee group or department.