Revenue Integrity Auditor

Job Title

Looking to join and lead a dynamic team at Ohio State University Physicians where excellence meets compassion?

Team Overview

With over 100 cutting-edge outpatient center locations, dedicated to providing exceptional patient care while fostering a collaborative work environment, our buckeye team includes more than 1,800 nurses, medical assistants, physicians, advanced practice providers, administrative support staff, IT specialists, financial specialists and leaders that all play an important part. As an employee of Ohio State University Physicians (OSUP), you'll be an integral part of a team committed to advancing healthcare, education, and professional growth.

Our Culture

At OSUP, we foster a culture grounded in the values of inclusion, empathy, sincerity, and determination. We meet our teams where they are, coming together to serve each other and our community.

Our Benefits

We know that having options and robust benefit plans are important to you. OSUP prioritizes the wellbeing of our team and that's why we offer our employees a flexible, competitive benefit package. In addition to medical, dental, vision, health reimbursement accounts, flexible spending accounts, and retirement, we also offer an employee assistance program, paid time off, holidays, and a wellness program designed to support our employees so they can live their best lives. As an OSUP employee, you will be eligible for these various benefits depending on your employment status.

Responsibilities

Provides charge auditing support throughout the organization to ensure integrity of charge processes and procedures from all sources. Collaborate with various OSUP corporate departments and OSUWMC to ensure timeliness and ensure the integrity of charging in the EPIC system.

Performs charge audits for identified potential missed charges to determine accurate ICD10, CPT, HCPCS used for billing services provided by physicians and licensed advance practice providers.

Identifies charge capture opportunities and works with respective departments to develop action plans for improvement.

Works in collaboration with various OSUP and OSUWMC departments to analyze and research billing concordance opportunities.

Coordinates with OSUP departments to ensure reconciliation and recoupment of charge opportunities.

Maintains knowledge of regulatory and industry updates, as well as medical compliance and reimbursement policies, such as medical necessity issues and correct coding issues.

Attends conferences, workshops, and inhouse sessions to receive updated coding information and changes in coding and/or regulations.

Keeps up to date with EPIC features and enhancements related to charging.

Acts as point person for professional revenue integrity program.

Creates and participates in active formal and informal communication on behalf of OSUP with other internal and external entities/customers.

Assists leadership in developing and monitoring charge capture methods and controls.

Identifies, researches, and communicates operational issues.

Participates in the development, implementation, testing, validation, and documentation of OSUP/OSUWMC revenue integrity initiative.

Prepares, reviews, and analyzes reports to make recommendations to manager.

Assists application developers and other support personnel with troubleshooting and resolution techniques.

Promotes quality documentation in the medical record supporting quality coding, compliance, high quality patient care, operations, research, and reimbursement.

Participates on committee or workgroups as needed.

Attendance, promptness, professionalism, the ability to pay attention to detail, cooperativeness with co-workers and supervisors, and politeness to customers, vendors, and patients.

Other duties or special projects as assigned.

Qualifications

Associate degree in healthcare, Business, Clinical, Computer Science or related field, and or 3 years in coding and charging experience, or an equivalent combination of education and experience.

Certification of CPC, CCS, CCS-P; or equivalent designation, along with a minimum of 3 years working with Electronic Medical Records.

Pay Range

USD $60,026.47 - USD $90,039.71 /Yr.