Senior Auditor, Revenue Optimization

🕒 il y a 10 jours

🐊 Florida – Distant

🐊 Florida – Remote

💵 $63 000 - $87 000 / an

⏰ Temps Plein

🟠 Senior

💰 Analyste Pricing

🦅 Parrain de Visa H1B

Cette entreprise a parrainé des visas H1B par le passé.

👻 Score fantôme 0%

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North American Partners in Anesthesia

Site WebLinkedInTous les Emplois

5001 - 10000 employés

🛡️ Assurance

📦 Logistique

🏥 Santé

Insurance • Logistics • Healthcare

En tant qu'organisation dirigée par des cliniciens, North American Partners in Anesthesia (NAPA) redéfinit les soins de santé, offrant une excellence inégalée à ses partenaires et à ses patients chaque jour. Depuis sa fondation par des médecins en 1986, NAPA est devenue l'une des principales entreprises de gestion de l'anesthésie et des services périopératoires à spécialité unique du pays, servant plus de 3 millions de patients chaque année dans plus de 500 établissements de santé à travers le pays.\n\nNos équipes de cliniciens hautement qualifiés participent à des programmes novateurs de développement du leadership et de formation au service client pour offrir des résultats optimaux aux patients, chirurgiens, administrateurs de soins de santé et personnel. Grâce à notre leadership exceptionnel en matière de soins périopératoires, de recherche, d'innovations et de technologies de pointe, NAPA propose des solutions réelles basées sur des résultats probants pour accélérer considérablement l'efficacité opérationnelle, augmenter les taux de satisfaction et améliorer la sécurité et la rentabilité.

Description

• Provide day-to-day functional leadership and technical support to Revenue Optimization Auditors • Serve as a primary Subject Matter Expert for audit processes, coding and billing questions, departmental policies, and workflow requirements • Provide guidance on complex cases, support workload coordination, reinforce departmental expectations, and escalate significant concerns to the Manager • Perform and support complex revenue optimization audits covering coding, billing, documentation, revenue integrity, and assigned audit activities • Evaluate records for accuracy, completeness, applicable requirements, under-coding, over-coding, missed billing opportunities, documentation deficiencies, and compliance concerns • Conduct scheduled quality assurance reviews of auditor work • Provide feedback, identify trends requiring education or process clarification, and communicate significant findings to management • Develop, review, and present audit results and supporting examples to management and stakeholders • Summarize findings, revenue opportunities, coding and documentation trends, compliance considerations, root causes, and corrective or preventive actions • Use reporting and data analytics tools to analyze audit populations and large datasets, identify patterns and anomalies, and evaluate revenue integrity concerns • Provide coaching, education, and technical guidance to Auditors, Coders, Physicians, and other stakeholders • Support onboarding and development of newly hired Revenue Optimization Auditors through workflow training, technical instruction, mentoring, case review, and feedback • Identify opportunities to strengthen audit methodology, standardize workflows, improve quality and efficiency, enhance reporting, and optimize revenue cycle outcomes • Coordinate and participate in team, departmental, and management meetings • Communicate operational updates, support resolution of escalated issues, and assist the Manager with priorities, coverage needs, and operational responsibilities • Serve as a senior subject matter expert and day-to-day functional leader within the Revenue Optimization Audit team

🎯 Exigences

• High school diploma or equivalent required • Current CPC or CCS certification, plus CPMA, CANPC, or an equivalent professional auditing or anesthesia coding certification • Minimum of 5 years of professional medical coding, auditing, revenue integrity, or revenue cycle experience, including significant experience auditing anesthesia services • Advanced knowledge of anesthesia coding, billing, documentation, and reimbursement requirements • Ability to interpret and apply CPT, ASA Crosswalk, ICD-10-CM, HCPCS, payer requirements, CMS guidance, and other applicable coding and billing regulations • Experience performing coding, documentation, revenue optimization, or compliance-focused audits • Strong analytical skills and ability to evaluate complex information, identify trends and root causes, and translate findings into actionable recommendations • Ability to provide technical guidance, coaching, training, and constructive feedback • Strong written and verbal communication skills • Strong organizational and time-management skills • Sound judgment, professionalism, discretion, and ability to appropriately escalate operational or compliance concerns • Proficiency with Microsoft Excel and other Microsoft Office applications • Ability to work effectively with audit, reporting, revenue cycle, and data analytics systems • Ability to work independently in a remote environment while maintaining effective communication and collaboration • Prior experience serving as a team lead, senior auditor, subject matter expert, trainer, or similar functional leadership role preferred • Experience conducting internal and/or external coding audits, revenue optimization audits, payer audits, or revenue integrity reviews preferred • Experience developing audit reports, presenting findings to leadership, and providing education based on audit results preferred • Experience analyzing audit data and identifying systemic revenue, coding, documentation, or workflow trends preferred

🏖️ Avantages

• Paid Time Off • Health insurance • Life insurance • Vision insurance • Dental insurance • Disability insurance • AD&D insurance • Flexible Spending Accounts/Health Savings Accounts • 401(k) • Leadership and professional development opportunities • Remote work environment