Chart Auditor - Revenue Cycle Operations - Full Time 8 Hour Days

Duties

• Validates, clears, and finalizes DNB edits either in the PFS host Patient Accounting system or claims editing system.
• Conducts insurance audits with designated payer auditor per contractual terms.
• Communicates with hospital departments including the PFS Business Office, and or insurance/payers on audits, disputed charges and hospital billing and charging problems.
• Completes charge audits or billing edits as necessary in a timely and accurate manner.
• Assists with training for new hires or temporary/contract staff.
• Communicates with insurance companies or auditing services to resolve complaints or defense audits.
• Completes department charge master updates and department requests timely and accurately.
• Schedules and conducts high dollar amount defense audits of patient medical records with insurance company representatives to verify documentation to support hospital.
• Validates and manages bill holds relating to charge reviews held by Risk Management.
• Coordinates approvals with Risk Management and bill release process.
• Conducts concurrent or focus audits to validate charge capture audits on randomly selected accounts monthly to identify charging issues which may indicate deficiencies in charge pathways and processes and target specific departmental issues.
• Consistently and thoroughly works DNFB and PFS claim edits work lists to ensure timely completion within Keck USC policies and monthly goals.
• Assists and supports the Director of Revenue Analysis and Director of A/R Management as assigned.
• Performs any other duties and responsibilities as assigned.

Required Qualifications

• High school or equivalent education.
• Read, write and follow written and verbal instructions.
• Good organizational skills and the ability to effectively handle multiple priorities and deadlines.
• Operate standard office equipment, for example, scanning equipment, fax machines, multi-line telephone system and copy machines.
• Work independently and as a team member.
• Maintain confidentiality of sensitive information.

Preferred Qualifications

• Specialized/technical training from an accredited program in one of the following areas: LVN, RN, Certified Coding Specialist or Professional Coder.
• One year of experience in medical auditing or HIM coding preferred.
• Computers and keyboarding skills, PC, Windows, Excel.
• Licensed Vocational Nurse - LVN (CA DCA) OR Registered Nurse - RN (CA DCA) OR Certified Coding Specialist - CCS (AHIMA) OR Certified Professional Coder - CPC (AAPC).

Required Licenses/Certifications

• Fire Life Safety Training (LA City).

Pay

The annual base salary range for this position is $68,640.00 - $112,370.00. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.