Job Information
Robert Half Chart Auditor in Los Angeles, California
Description We are in search of a meticulous Sr. Auditor to join our healthcare team in Los Angeles, California. The role involves auditing various aspects of our healthcare operations, including hospital departments, billing issues, and charge audits. You are expected to communicate effectively with various stakeholders, from department directors to insurance companies, to resolve disputes and improve our billing and charging systems.
Responsibilities:
• Engage in regular interactions with various hospital departments to address audits, disputed charges, and billing and charging problems.
• Communicate effectively with hospital department directors on a weekly or as needed basis to resolve outstanding or missing documentation or charging issues.
• Conduct timely and accurate charge audits or billing edits as necessary.
• Assist with training for new team members.
• Ensure compliance with hospital guidelines.
• Interact with insurance companies or auditing services to resolve complaints or defense audits.
• Regularly update department charge master and process department requests accurately and promptly.
• Communicate with hospital departments as needed regarding billing, charging, and documentation problems.
• Find and implement solutions to existing charging problems.
• Coordinate high dollar amount defense audits of patient medical records with insurance company representatives to verify documentation to support hospital charges.
• Validate and manage bill holds relating to charge reviews held by Risk Management, and coordinate approvals with Risk Management and bill release process.
• Conduct concurrent or focus audits to validate charge capture audits on randomly selected accounts monthly to identify charging issues which may indicate deficiencies in charge pathways and processes and target specific departmental issues.
• Work consistently and thoroughly on DNFB and PFS claim edits worklists to ensure timely completion within policies and monthly goals.
• Assist and support the Director of Revenue Analysis and Director of A/R Management as assigned.
• Perform any other duties and responsibilities as assigned. Requirements
• Minimum of 7 years of experience in a similar role within the healthcare, hospitals, or social assistance sector
• Knowledge and understanding of application controls, audit findings, and compliance
• Proven ability in conducting audits, credit risk management, and dispute resolution
• Ability to create and manage documentation
• Experience in medical chart and claims audits
• Familiarity with auditing practices and procedures
• Strong communication skills, both written and verbal
• High degree of professional ethics and integrity
• Excellent problem-solving abilities
• Knowledge of industry regulatory standards and compliance requirements
• Strong computer skills, including MS Office, databases, and audit software
• Ability to handle multiple projects and deadlines
• CCS or CPC Certification required
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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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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