Healthcare Auditor - Epic Resolute Hospital Billing & Chargemaster

Healthcare Auditor - Epic Resolute Hospital Billing & Chargemaster

Posted 1 day ago by 1758017040

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Negotiable
Outside
Remote
USA
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Auditing Billing Consolidation Data Analysis External Auditing Income / Revenue Information Systems Management Microsoft Excel Microsoft Office Revenue Cycle Management Software Coding

Summary: The Healthcare Auditor will support the Chargemaster and Revenue Cycle Management team by maintaining and analyzing the Charge Master for compliance and integrity. This role involves performing audits, providing education on charging regulations, and collaborating with various departments to ensure accurate charge processes. The position requires strong analytical skills and knowledge of coding standards to resolve complex charging issues effectively.

Key Responsibilities:

  • Assist with the maintenance of the Charge Description Master (CDM) due to regulatory requirements and service requests.
  • Collaborate with Information Systems to support applications for order entry and charges in specific disciplines.
  • Serve as a resource for staff on revenue generation and charge master issues, providing education on regulations.
  • Develop and implement strategic goals for standardization and consolidation of charge/revenue systems.
  • Ensure timely communication and maintain reliable internet access for remote work.
  • Follow company policies and interact positively with colleagues.
  • Prioritize and multitask effectively.
  • Construct charges promptly to facilitate the revenue cycle process and resolve complex charging issues.
  • Educate clinical departments on charge selection and assist with Supply Chain Management for chargeable items.
  • Perform other duties as assigned.

Key Skills:

  • Two years of experience in Chargemaster, Revenue Integrity, Auditing, Utilization Management, Coding, or Hospital Billing.
  • Working knowledge of CPT, HCPCS Level II, Local Level III, and ICD10 coding.
  • High level of critical thinking skills.
  • Proficient in Excel for reports and data analysis.
  • Strong verbal and written communication skills.
  • Experience with Epic Resolute Hospital Billing.
  • RN/LPN license or healthcare-related degree required.
  • CPC, CCS, or relevant coding or auditing certification preferred.
  • Competent with MS Office, especially Excel.

Salary (Rate): undetermined

City: undetermined

Country: USA

Working Arrangements: remote

IR35 Status: outside IR35

Seniority Level: undetermined

Industry: Other

Detailed Description From Employer:

Please contact Abdul on "" OR email me at ""

Description - External

Purpose Statement / Position Summary

CDM Auditor will assist the Chargemaster, RCM team in maintaining and analyzing the Charge Master (CDM) for charge component and revenue cycle integrity; monitoring compliance with Federal and State guidelines, performing periodic audits and provide education of Charge Description Master.

Essential Functions and Responsibilities of the Job

Assist with the maintenance of CDM due to regulatory requirements as well as requests for services including but not limited to charge description, revenue Code, CPT, modifiers and cost center for updates to the A/R system.
Works collaboratively with IS to support applications and their subsystems for order entry and subsequent charges for specific discipline; i.e. laboratory, imaging, cardiology.
Serves as a resource for staff throughout the health system involved in the revenue generation and charge master related issues and provides education on use of the Charge Master on the charging regulations.
Develop and implements strategic goals of standardization and consolidation of charge/revenue systems and structures.
Be at work and be on time. Prepared for meetings, works on assignments, and provides feedback on projects. Reliable internet access and maintains connectivity. Communicates timely by phone, email, and/or other departmental resources.
Follow company policies, procedures and directives.
Interact in a positive and constructive manner.
Prioritize and multitask.

Qualifications - External

Essential Job Outcomes

Constructs charges in a timely manner to facilitate timely revenue cycle process.
Resolves complex charging issues.
Assures Charge Navigators are optimal and user friendly with CPT details for accurate charging.
Collaborates with ancillary systems and assigns appropriate CDM s for ordered procedures, supplies and implants.
Educates ancillary/clinical departments regarding charge selection for service provided.
Assists with Supply Chain Management in determining appropriate charge for chargeable item.
Other duties as assigned .

Experience

Two years experience in Chargemaster, Revenue Integrity, Auditing, Utilization Management, Coding, or Hospital Billing. Charge Master maintenance in a multi-hospital system preferred.
Working knowledge of CPT, HCPCS Level II, Local Level III, and ICD10 coding and associated clinical expertise.
Demonstrate a high level of critical thinking skills.
Utilizes Excel for reports and data analyses.
Strong verbal and written skills.
Epic Resolute Hospital Billing.

Education

RN/LPN license or healthcare related degree required.
CPC, CCS, or relevant coding or auditing certification preferred.
Competent with MS Office with strong emphasis/skilled on Excel.

Please contact Abdul on "" OR email me at ""

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