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The auditor conducts comprehensive revenue cycle audits, including coding, billing, and collections, to ensure system integrity and compliance. They also analyze claim workflows and payer rejections to identify root causes and implement corrective actions.
Position Requirements
PRIMARY RESPONSIBILITIES
Conduct comprehensive revenue cycle audits covering registration, coding, billing, and collections.
Evaluate system performance including billing system integrity, implementation outcomes, and maintenance of dictionaries and configurations.
Support billing and charge correction reviews based on audit findings and track resolutions.
Analyze claim workflows to identify root causes for delayed or inaccurate reimbursements.
Works closely with cross functional teams to troubleshoot and resolve system or interface-related errors.
Analyzing payer claim acknowledgment rejections collaboratively with the Accounts Receivable (A/R) department to identify root causes, recommend corrective actions, and ensure timely and accurate claims processing and payment.
Audit coding accuracy and completeness; collaborate with Revenue Optimization Audit team and validate compliance with ICD-10, CPT, and HCPCS standards.
Prepare technical audit reports, dashboards, and corrective action plans.
Perform pre-correction reviews to hand off to charge correction team to ensure the accuracy and adherence to payer guidelines and NAPA policies, avoiding any risk to revenue collected.
REQUIRED QUALIFICATIONS
•Current Certified Professional Coder (CPC) from AAPC or AHIMA required or must be obtained within 1 year.
•4–6 years of auditing or revenue cycle experience. Anesthesia specialization is highly preferred.
•Proficiency in claims, denial trends, payer contract interpretation.
•Advanced understanding of revenue cycle processes, medical billing systems, and healthcare compliance standards.
•In-depth knowledge of healthcare billing systems (Athena, Epic, Cerner, or similar).
•Advanced Excel skills and familiarity with audit tools and data analytics platforms.
•Strong analytical thinking, attention to detail, and cross-functional collaboration skills.
Total Rewards
Generous benefits package, including:
Paid Time Off
Health, life, vision, dental, disability, and AD&D insurance
Flexible Spending Accounts/Health Savings Accounts
401(k)
Leadership and professional development opportunities
EEO Statement
North American Partners in Anesthesia is an equal opportunity employer.
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