Auditor II, Revenue Cycle

This is a fully remote position, open to applicants in Florida.

📋 Description

• Execute thorough revenue cycle audits encompassing registration, coding, billing, and collections.

• Assess system performance, including the integrity of billing systems, outcomes of implementations, and the upkeep of dictionaries and configurations.

• Assist in billing and charge correction reviews based on audit results and monitor resolutions.

• Examine claim workflows to pinpoint root causes of delayed or erroneous reimbursements.

• Collaborate closely with cross-functional teams to diagnose and resolve errors related to systems or interfaces.

• Analyze payer claim acknowledgment rejections in conjunction with the Accounts Receivable department to determine root causes, suggest corrective measures, and guarantee timely and accurate claims processing and payments.

• Review coding for accuracy and completeness while ensuring compliance with ICD-10, CPT, and HCPCS standards.

• Create detailed technical audit reports, dashboards, and action plans for corrective measures.

• Conduct pre-correction reviews for the charge correction team to verify accuracy and compliance with payer guidelines and NAPA policies.

• Detect billing discrepancies, system inefficiencies, and compliance risks throughout the revenue cycle.

⛳️ Requirements

• Active Certified Professional Coder (CPC) certification from AAPC or AHIMA is required or must be acquired within one year.

• 4–6 years of experience in auditing or revenue cycle management.

• Specialization in anesthesia is highly preferred.

• Expertise in claims, denial trends, and interpretation of payer contracts.

• Advanced knowledge of revenue cycle processes, medical billing systems, and healthcare compliance regulations.

• Extensive familiarity with healthcare billing systems such as Athena, Epic, Cerner, or similar platforms.

• Proficient in Excel at an advanced level.

• Experience with audit tools and data analytics platforms.

• Strong analytical skills, attention to detail, and ability to collaborate across functions.

🏝️ Benefits

• Paid Time Off

• Health insurance

• Life insurance

• Vision insurance

• Dental insurance

• Disability insurance

• AD&D insurance

• Flexible Spending Accounts/Health Savings Accounts

• 401(k)

• Opportunities for leadership and professional development