Payment Integrity AuditorVirtualVocations • Orlando, Florida, United States
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Payment Integrity Auditor
VirtualVocations • Orlando, Florida, United States
[job_card.variable_days_ago]
[job_preview.job_type]
- [job_card.full_time]
[job_card.job_description]
A company is looking for a Payment Integrity Auditor to ensure accurate claims payment and uphold compliance through detailed chart reviews.
Key Responsibilities
Perform medical chart reviews to ensure adherence to billing and payment policies
Review inpatient charts for DRG assignment validation based on coding guidelines
Collaborate with providers to resolve audit disputes and maintain audit documentation
Required Qualifications
Bachelor's degree in a health care-related field or business-related discipline preferred
Current credentials of CPC, RN, or RHIT / RHIA / CCS
Strong knowledge of medical terminology and ICD-10-CM / PCS coding guidelines
Inpatient Medical Chart Review experience is required
Understanding of Inpatient and Outpatient Prospective Payment System regulations
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