Rev Cycle Internal Auditor

Core Duties and Responsibilities

• Plan, coordinate, and manage projects to ensure project initiatives and timelines are met, working with outsourced teams to develop and define project scope and initiatives
• Collaborate with and communicate project initiatives with business stakeholders to facilitate active engagement and timely response to requests
• Prepare, present, and distribute project status reports to stakeholders
• Analyze clinical and financial data to find discrepancies and work with various teams to improve the revenue cycle, resolve billing issues, and ensure proper reimbursement for healthcare services
• Follow up on corrective action measures related to outcomes of project activities
• Evaluate audit results to determine risk exposure, impact to revenue cycle, identify clinical documentation improvement opportunities, and make recommendations for areas of continued audit focus
• Identify trends based upon audit results and provide recommendations for education, training and corrective actions to internal stakeholders, as needed
• Maintain knowledge of new/existing government regulations and third-party payor requirements with regard to documentation, coding and billing requirements
• Maintain professional credentials through continuing education as required by national and state accreditation organizations
• Work independently, use varying resources to conduct research over subject matter topics, identify opportunities for improvement and provide solutions, and coordinate multiple projects simultaneously
• Communicate effectively across various cross-functional departments
• Represent Albany Med Health System in a professional manner at all times and in all interactions

Minimum Qualifications

• Education: Minimum Bachelor’s degree required
• Licensure, Certification & Registration: Certified Professional Coder (CPC) designation or other Coding Professional Certifications required
• Experience: 4+ years’ experience within the healthcare industry and coding experience required

Skills, Knowledge & Abilities

• In-depth knowledge of hospital revenue cycle and understanding of the Charge Description Master (CDM), charge errors, and charge reconciliation process; EPIC experience a plus
• Strong verbal and written communication skills to effectively teach and interact with internal and external parties
• Strong organizational, project management and leadership skills required