Job Information
Robert Half Medical Chart Auditor in Alhambra, California
Description
We are seeking a Medical Chart Auditor to join our team in the Healthcare industry, located in Los Angeles, California. This role offers a contract to hire employment opportunity and involves a range of responsibilities including auditing and rectifying patient records, conducting insurance audits, and liaising with various hospital departments and insurance firms.
Responsibilities:
• Verify and adjust edits in the Patient Accounting System or claims editing system.
• Conduct insurance audits alongside selected payer auditors.
• Communicate with various hospital departments regarding charge disputes, charge capture, and waiting documentation.
• Engage with department directors about outstanding documentation or charging issues.
• Perform timely and accurate charge audits or billing edits as required.
• Handle bill holds related to charge reviews held by Risk Management, coordinating approvals and bill release process.
• Work with insurance companies or auditing services to address grievances or conduct defense audits.
• Update the department charge master and respond to department requests promptly and accurately.
• Identify and resolve any pre-existing charging issues.
• Organize and carry out extensive defense audits of patient medical records with insurance company representatives.
• Correct charges and coordinate re-bills based on audit results.
• Provide support to the Director of Revenue Analysis and Director of A/R Management as needeWe are currently seeking a meticulous Chart Auditor responsible primarily for verifying, rectifying, and finalizing edits in the Patient Accounting System or claims editing system. The Chart Auditor will occasionally conduct insurance audits in conjunction with chosen payer auditors as per contract stipulations. This role will also involve communication within the hospital concerning charge disputes, charge capture, and pending documentation.
Key Responsibilities:
Collaborate with various hospital departments and insurance/payers on audits, disputed charges, and hospital billing issues.
Engage with department directors concerning outstanding documentation or charging problems.
Conduct accurate and timely charge audits or billing edits as needed.
Assist in the onboarding and training of new recruits or temporary/contract team members.
Communicate with insurance firms or auditing services to address any grievances or conduct defense audits.
Update the department charge master and respond to department requests timely and accurately.
Address any billing, charging, or documentation difficulties with relevant hospital departments.
Identify and resolve any longstanding charging issues.
Organize and carry out extensive defense audits of patient medical records with insurance company representatives.
Correct charges and coordinate re-bills based on agreed audit results.
Validate and handle bill holds related to charge reviews, coordinating approvals and bill release process.
Carry out concurrent or focus audits to validate charge capture audits on randomly selected accounts monthly.
Work consistently on DNFB and PFS claim edits worklists to ensure timely completion.
Provide support to the Director of Revenue Analysis and Director of A/R Management.
Perform any other duties and responsibilities as directed.
Requirements
Required Qualifications:
High school diploma or equivalent.
Able to read, write, and follow both written and verbal instructions.
Familiarity with the Medical Record Department operations.
Excellent organizational skills to manage multiple tasks and deadlines.
Proficiency in standard office equipment operation.
Ability to work independently and in a team.
Confidentiality of sensitive information.
Coding experience, preferably certified.
Facility billing experience.
Charging, CDM experience
Preferred Qualifications:
Graduation from an accredited program such as LVN, RN, Certified Coding Specialist, or Professional Coder.
Minimum of one-year experience in medical auditing or HIM coding.
Advanced computer and keyboarding skills.
Relevant certification such as Licensed Vocational Nurse - LVN (CA DCA), Registered Nurse - RN (CA DCA), Certified Coding Specialist - CCS (AHIMA), or Certified Professional Coder - CPC (AAPC).
Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.
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Robert Half will consider for employment qualified applicants with arrest or conviction records in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.
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