[Hiring] Revenue Integrity Auditor @ECU Health Medical Center

Role Description

Perform Charge Capture Reconciliation Audits for all hospitals with the ECU Health System to ensure compliance of Health System Departmental Charge Capture and Reconciliation Policy.

• Report findings via a monthly Revenue Integrity Audit Scorecard for each facility audited.
• Assist Revenue Integrity Leadership in facilitating monthly meetings to discuss findings with each area audited.
• Assist Departmental Leadership in the development of corrective action plans and training for non-compliant areas.
• Re-audit to ensure improvement plans and training have improved charge reconciliation compliance rates.
• Maintain expertise on Third Party Billing Regulations and Requirements to ensure Epic EAP/CDM remains in compliance.
• Develop tools to provide education and communication to Revenue Producing Departments.
• Analyze reimbursement and charge data for service line analysis and other special projects as needed.
• Develop and maintain understanding of systems involved in the updating of charges as well as PC related skills.

Qualifications

• Bachelor's Degree preferred.
• 3 - 4 years of experience required.
• RHIA/RHIT certification preferred.
• Physician Billing Charging and/or Coding Experience is preferred.
• Demonstrated ability to manage, teach, make independent decisions and assume responsibility.
• Strong interpersonal communication skills, verbal and written.
• Ability to communicate and work effectively with all levels of staff.
• Working knowledge and experience with PC-based applications, i.e. Word, Excel, PowerPoint, Outlook.
• Ability to function as a leader, team member and execute the desired outcomes.
• Must exhibit creative, positive problem-solving abilities.
• Ability to foster collaboration between multiple parties.
• Ability to plan, organize and effectively present ideas and concepts to groups.
• Ability to think conceptually and apply concepts in a practical application.
• Ability to assimilate information from a variety of sources, analyze information, and determine a course of action.
• Ability to consider diverse opinions and incorporate them into the decision-making process.
• Commitment to a high standard of customer service.

Requirements

• Ensure compliance of the ECU Health Charge Capture Reconciliation Policy is upheld by each revenue generating department across the system.
• Lead, develop and facilitate a robust audit program that continuously monitors the usage of charge reconciliation reports and charge review work queues.
• Maintain facility specific scorecards to include corrective action plans for non-compliant departments.
• Escalate non-compliant departments to designated Leadership and work with appointed individuals to ensure corrective action plans and/or training are being administered.
• Work with Revenue Integrity leadership to conduct a monthly Revenue Integrity Audit Scorecard Read-Out to each facility's leadership.
• Share monthly audit results and corrective action plans with finance and clinical leadership.
• Remain up-to-date on Third Party Billing Regulations by reviewing regulatory/contractual updates and communications.
• Answer all questions regarding the appropriateness of charging for services and products.
• Keep up-to-date on EPIC or other related EAP software functionality.
• Understand the hospital billing system processes and related clinical systems.
• Use Excel or other necessary software to manipulate, summarize, and analyze data.

Benefits

• Remote role (based out of Greenville, NC).
• Monday - Friday full-time day shift.
• Great Benefits.

Company Description

ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.

The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Children’s Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research.