Billing Auditor

Billing Auditor

We are seeking a detail-oriented and analytical Billing Auditor to join our team. In this role, you will ensure the accuracy, completeness, and regulatory compliance of billing documentation across the revenue cycle. You will conduct audits, prepare reports, collaborate with internal teams, and support the organization's commitment to quality and ethical standards.

Audit & Review

• Perform systematic reviews of claims billing to ensure quality, completeness, and accuracy throughout the revenue cycle.
• Conduct random patient encounter audits across various locations.
• Review audit work documents and admission documentation from the EHR for accuracy, completeness, and compliance with corporate policies and procedures.
• Plan and conduct audits related to revenue cycle processes or regulatory requirements, including Medicare and Medicaid compliance.
• Audit revenue cycle reports to verify accurate reporting of revenue, receipts, discounts, and related financial activity.

Reporting & Analysis

• Prepare clear and comprehensive audit findings for leadership, including the Senior Director of Risk & Quality, Director of Revenue Integrity, Corporate Compliance Manager, and CFO.
• Analyze revenue cycle data to identify discrepancies, trends, and improvement opportunities while ensuring compliance with HIPAA, CMS, and other healthcare regulations.
• Provide detailed summary reports and supporting documentation for all audit outcomes.

Compliance & Process Improvement

• Ensure all appropriate billing charges are captured, documented, and reimbursed in accordance with policies, procedures, and regulatory requirements.
• Identify opportunities to strengthen charge capture processes, improve internal controls, and implement best practices to enhance compliance and revenue integrity.
• Respond to third-party audits, including charge recovery and regulatory audits.
• Provide training and education to clinical and program staff on documentation standards and charge capture processes.

Organizational Responsibilities

• Uphold the organization's Mission, Vision, Core Values, Philosophy of Care, and Code of Ethics in all interactions and decision-making.
• Maintain required training certifications, licensing, and regulatory accreditations.
• Communicate effectively with colleagues, individuals served, and family members when applicable.
• Cooperate fully with inspections and investigations conducted by state or licensing agencies.
• Maintain a safe, respectful environment, reporting any concerns related to safety, compliance, abuse, neglect, discrimination, or policy violations.
• Adhere to all laws, regulations, organizational policies, and ethical guidelines.
• Follow individual supervision requirements outlined in relevant care or service plans (e.g., IPP, ISP, IEP), when applicable.

Why Join Us?

• Meaningful work that supports quality care and ethical operations.
• Collaborative environment committed to professional growth and continuous improvement.
• Opportunities to influence organizational practices and enhance compliance and revenue integrity.

Qualifications

Bachelor's degree from an accredited college or university in accounting, finance, or healthcare administration.

Minimum of five years of revenue cycle management experience and/or revenue auditing experience in a healthcare setting, with a strong preference for prior audit experience.

Special Skills

• Experience in billing audits, healthcare revenue cycle, compliance, or related field.
• Knowledge of HIPAA, CMS, Medicare/Medicaid, and healthcare regulatory guidelines.
• Strong analytical, organizational, and communication skills.
• Proficiency with EHR systems and audit documentation processes.
• Ability to prepare detailed reports and collaborate across departments.

EEO Statement

Bancroft stands strong against racism and hate of all kinds and supports actions leading to respect, equality, fairness, and peace. We advocate for and embrace an inclusive and just world. One world. For everyone. We work with heart, respect, and collaboration. We are communicators, listeners, problem solvers, partners, and collaborators. Bring your authentic self to our team.

Bancroft is an Equal Opportunity Employer, and supports diversity, equity, and inclusion in its hiring and employment practices, so that every team member can feel a true sense of belonging, and maximize their unique potential. To this end, all applicants will receive consideration for employment without regard to age, race, color, religion, sex, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, veteran status or any other characteristic protected by law.