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Auditor works with other departments to gather information, conduct internal audits set forth in OIG Work Plan . Bill Auditor, together with other members of the department, prepares Corrective Action Plans, conducts education and training and monitors for progress toward improved .

Job Summary Under direction of Compliance Officer, Bill Auditor is responsible for bill auditing with overall goal of ensuring charges were billed and paid accurately. Bill Auditor examines medical records, billing information, payment histories, medical processes and regulations to identify inaccuracies, compliance issues and inefficiencies. Bill Auditor is responsible for responding to requests from Medicare, government entities and third party auditors and initiating either appeals or paybacks based on relevant regulations and guidelines. Bill Auditor works with other departments to gather information, conduct internal audits set forth in OIG Work Plan and identifies "problem areas" within the facility. Bill Auditor, together with other members of the department, prepares Corrective Action Plans, conducts education and training and monitors for progress toward improved performance and compliance. Other duties include entering information and comments to tracking system and HMS to ensure responses to audit requests are communicated to other departments and occur within required timeframe, monitoring impact of audits on facility's resources and conducting 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: "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 = "Continuously". 1. Standing/Walking - Occasional 2. Sitting - Frequent 3. Bending - Occasional 4. Climbing/Reaching - Occasional 5. Push/Pull - Occasional 6. Handling/Lifting - Occasional 7. Manual Dexterity a. HANDS - Simple grasp - Continuous; Firm grasp - Occasional; Fine manipulation - Occasional b. FEET - Continuous 8. Speaking/Hearing/Seeing 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. Bachelor's 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.

Baptist Memorial Health Care

Compliance Bill Auditor

Auditing

Billing

Billing Records

Communication Skills

Content Management Systems (CMS)

Corrective Action

Data Collection

Government

Healthcare

Identify Issues

Internal Audit

Maintain Compliance

Manual Dexterity

Medical Billing

Medical Records

Medicare

Physical Demands

Project Planning

Regulations

Training/Teaching

Jobvite Talemetry Organic Easy Apply

OIG Work Plan and identify "problem areas" within the facility where changes to organizational practices, policies or procedures might be needed to enhance organizational efficiencies and effectiveness. Appeals, Nurse Auditor will be responsible for responding to external audits including writing appeals, working .

Job Summary Under the direction of Compliance Officer, within Department of Compliance Audit and Appeals, Nurse Auditor will be responsible for responding to external audits including writing appeals, working with Medical Staff and other staff. Nurse Auditor will be responsible for facility's communication and interactions with CMS, Recovery Audit Contractors (RAC) and other third party auditors. Nurse Auditor will document information and comments into the facilities tracking system to ensure audit deadlines are met. Nurse Auditor will work with other departments to gather information, conduct internal audits set forth in the OIG Work Plan and identify "problem areas" within the facility where changes to organizational practices, policies or procedures might be needed to enhance organizational efficiencies and effectiveness. Nurse Auditor, together with other members of the department, will prepare and monitor Corrective Action Plans, conduct education and training and monitor for progress toward improved performance and compliance. Other duties include conducting audits to identify problems and assisting the CFO as needed with Healthgrades, MACRA/MIPS, data collection, analysis and ultimately educating physicians for improvement. Qualifications: 1. Bachelor's degree in nursing from an accredited program required. 2. Master's Degree in nursing, business or other health care related field preferred. 3. Current Mississippi Registered Nurse License. 4. Relevant Experience in a hospital setting. 5. Strong knowledge of state and federal law and regulations. 6. Understanding of CMS coverage and payment methodologies. 7. Excellent oral and written communication skills. 8. Advanced computer proficiency. 9. Excellent organizational skills and attention to detail. 10. Coding experience preferred. 11. Previous audit experience preferred. 12. Knowledge of InterQual and Principles of Managed Care preferred.

Auditing Jobs in Starkville, MS

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Auditing Jobs in Starkville, MS

Compliance Bill Auditor Baptist Memorial Health Care

Compliance Nurse Auditor Baptist Memorial Health Care

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