Revenue Integrity Auditor

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October 10

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ACU-Serve

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Healthcare Insurance • Fintech • SaaS

ACU-Serve is a company that specializes in optimizing revenue cycles for healthcare providers, particularly in the HME (Home Medical Equipment) and DME (Durable Medical Equipment) sectors. They focus on increasing clean claims through strategic partnerships, innovative solutions, and advanced technology. ACU-Serve's comprehensive approach includes revenue cycle management, A/R collection services, and resupply for infusion pharmacy and complex rehabilitation services, ensuring swift and accurate payments while enhancing client education and operational efficiency.

501 - 1000 employees

⚕️ Healthcare Insurance

💳 Fintech

☁️ SaaS

📋 Description

• Conduct comprehensive audits of billing, collecting, and reimbursement processes. • Monthly auditing of each analyst aging with a random spot checks up to 50 accounts to ensure their current processes, notation of accounts, and course of action to align with Pinnacle’s guidelines for success. • Review patient accounts for accuracy and completeness. • Perform special project audits and reviews as requested by departments. • Participate in staff performance improvement plans by providing additional auditing and/or basic coaching as needed to management and training team. • Communicate with management regarding trends to improve employee workflow and re-education. • Collaborate with training management/staff to achieve employee and company goals. • Collaborate with leadership to develop new SOP’s and update existing SOP’s when changes occur. • Identify and report discrepancies, errors, and potential areas for improvement. • Ensure compliance with federal, state, and local regulations, as well as internal policies. • Collaborate with billing, collections and cash teams to resolve identified issues. • Prepare detailed audit reports and present findings to management. • Monitor and analyze key performance indicators related to the revenue cycle. • Provide recommendations for process improvements to enhance revenue cycle efficiency. • Stay updated on industry trends, regulations, and best practices.

🎯 Requirements

• Minimum high school diploma or GED required. • Minimum of 3 years of experience in revenue cycle management, billing, or coding, preferably in the home infusion, AIC/AIS field. • Post-secondary education in a medical discipline highly desired but not required. • Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification is desirable not required. • Strong knowledge of healthcare billing and coding regulations. • Excellent analytical and problem-solving skills, with the ability to recognize trends. • Attention to detail and high level of accuracy. • Strong communication and interpersonal skills. • Proficiency in revenue cycle management software and Microsoft Office Suite, including CPR+, CareTend, WeInfuse, Waystar, pivot tables, Excel, Word, Windows, BI, Power BI, and Access, would be desired.

🏖️ Benefits

• Competitive salary • Flexible working hours • Professional development budget • Home office setup allowance • Global team events