Senior Clinical Quality Auditor performing internal audits, analyzing results, and collaborating with clinical operations teams at DaVita. Assisting leadership with daily operations of the Clinical Quality Auditing team.
About the role
- Billing Auditor evaluating Revenue Cycle outcomes at Planned Parenthood of Central and Western New York. Collaborating with teams to improve billing practices and ensure compliance.
Responsibilities
- Evaluates charge capture, claims scrubbing, and sliding fee discount practices
- Maintains and ensures a disciplined and effective approach to discover root causes of billing issues
- Reports to Revenue Cycle Management and Quality Risk Management Committees
- Develops and recommends corrective action plans
- Recommends modifications to established practices based on findings
- Supports the documentation of Revenue Cycle Standard Operating Procedures (SOPs)
- Works collaboratively with the Revenue Cycle Leadership
- Builds and manages relationships with Payers
- Manages individual projects as assigned and provide weekly status reports
- Performs data processing, analysis, and reporting of Revenue Cycle activities
Requirements
- Bachelor’s degree in Business or Healthcare Administration or related field preferred
- Certified Professional/Medical Coder or Certified Professional Medical Auditor desired
- Minimum 3 years of experience in medical billing and collections
- Minimum 3 years of experience with computerized billing/receivables system and reports
- Experience with NextGen practice management system preferred
- In-depth knowledge of Governmental and non-Governmental insurance guidelines
- In-depth knowledge of ICD, CPT, and HCPCS coding
- Ability to read and interpret medical procedures and terminology
- Must have excellent communication skills (verbal and written)
- Must be sensitive to patient’s financial and clinical needs
- Must have exceptional attention to detail
- Must demonstrate strong analytical and problem-solving skills
- Must have strong interpersonal skills
- Computer skills must include advanced level in Excel and other MS Office programs
- Must be able to work a flexible schedule with ability to travel to multiple sites when needed
- Must have reliable transportation and/or a valid driver’s license not in jeopardy of being revoked.
Benefits
- Paid Time Off
- 10 paid holidays
- Affordable medical, dental, and vision options
- Health Savings Account or Flexible Spending Account
- 401(k) with match
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