Compliance Bill Auditor

Compliance Bill Auditor in Starkville, Mississippi, United States

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Compliance Bill Auditor Job ID COMPL001215 Job Category: Quality Compliance & Safety Job Type: Full-Time

Facility: Baptist Memorial Hospital Oktibbeha County Location: Starkville, MS

Job Summary

Under the direction of a Compliance Officer, the Bill Auditor is responsible for bill auditing with the overall goal of ensuring charges were billed and paid accurately. The Bill Auditor examines medical records, billing information, payment histories, medical processes, and regulations to identify inaccuracies, compliance issues, and inefficiencies.

Responsibilities

• Respond to requests from Medicare, government entities, and third-party auditors and initiate either appeals or paybacks based on relevant regulations and guidelines.
• Work with other departments to gather information, conduct internal audits, and set forth in OIG Work Plan, and identify problem areas within the facility.
• Prepare Corrective Action Plans, conduct education and training, and monitor progress toward improved performance and compliance.
• Enter information and comments to the tracking system and HMS to ensure responses to audit requests are communicated to other departments and occur within the required timeframe.
• Monitor the impact of audits on the facilitys resources and conduct focus audits to identify areas where change to organizational practices, policies, or procedures might be needed to enhance organizational efficiencies and effectiveness.

Physical Demands

Note: The physical demands of this job are as follows:

• Occasionally 1 to 33 of the workday
• Frequently 34 to 66
• Continuously 67 to 100

This may also be described as performance once every 3 minutes Occasionally once every 1 ½ minutes to 3 minutes Frequently once every 1 ½ minutes to continuous work

Physical Demands (continued)

1. Standing
2. Walking - Occasional
3. Sitting - Frequent
4. Bending - Occasional
5. Climbing
6. Reaching - Occasional
7. PushPull - Occasional
8. Handling
9. Lifting - Occasional
10. Manual Dexterity a. HANDS - Simple grasp - Continuous b. Firm grasp - Occasional c. Fine manipulation - Occasional
11. FEET - Continuous
12. Speaking a. SPEAKING - Able to communicate verbally with co-workers, patients, and visitors b. HEARING - Functional with or without correction c. SEEING - Functional with or without correction

Qualifications

1. Bachelors Degree
2. Experience working in a hospital setting with billing auditing
3. Knowledge and understanding of healthcare laws and regulations, CMS coverage and payment methodologies, coding and billing, and audit practices
4. Computer skills and applications required for audits and research

Equal Opportunity

Baptist is an equal employment opportunity employer and prohibits discrimination based on an individuals race, color, religion, national origin, pregnancy, sex, age, handicap, disability, physical, visual, or mental creed, marital, and veteran status, genetic information, or any other category protected by federal or state law, with respect to all aspects of the employment process, including recruitment, selection, placement, promotion, wages, benefits, and other terms and conditions of employment.

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