Provider Documentation, Billing Auditor

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🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🔎 Auditor

👻 Ghost score 12%

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Mary Free Bed Rehabilitation Hospital

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1891

🏥 Healthcare

🤝 Non-profit

📚 Education

💰 $3M Grant - Mary Free Bed Rehabilitation Hospital on 2023-01

Healthcare • Non-profit • Education

<Mary Free Bed Rehabilitation Hospital> is a leading rehabilitation hospital and health system based in Grand Rapids, Michigan that restores function and independence through specialized inpatient and outpatient rehabilitation services. It provides care across numerous specialties including spinal cord and brain injury, stroke, amputation, cancer rehabilitation, orthotics & prosthetics (bionics), respiratory and cardiac rehab, and adaptive sports, and operates many regional locations and partnerships. The organization offers education and training programs (residencies, fellowships), conducts research and uses advanced rehabilitation technologies (robotics, motion analysis, virtual rehab), and is supported by a foundation and volunteer/donor programs. Mary Free Bed is accredited by CARF and emphasizes a continuum of care focused on patient outcomes and community access.

📋 Description

• Conduct independent audits and reviews of provider documentation, coding, billing, and reimbursement practices • Evaluate clinical documentation accuracy, completeness, and adequacy against coding, billing, medical necessity, regulatory, payer, and organizational requirements • Perform ongoing monitoring to identify compliance risks, billing vulnerabilities, coding trends, and process improvement opportunities • Identify potential overpayments, underpayments, coding inaccuracies, documentation deficiencies, and other compliance concerns • Recommend corrective actions and help prevent documentation and billing issues • Collaborate with compliance staff, providers, advanced practice providers, revenue cycle staff, operational leaders, and other departments • Provide education and training on documentation requirements, coding standards, billing regulations, compliance expectations, and best practices • Serve as a subject matter resource on documentation integrity, coding, billing compliance, reimbursement requirements, and regulatory developments • Assist with developing, reviewing, and revising policies, procedures, and internal controls • Maintain accurate audit workpapers, documentation, reports, and records • Monitor changes in healthcare laws, regulations, payer guidance, coding requirements, and industry best practices and assess organizational impact • Promote integrity, ethical conduct, accountability, and regulatory compliance throughout the Mary Free Bed system • Perform other duties and special projects assigned by the Compliance Officer • Demonstrate excellent customer service, encourage and monitor service standards, promote teamwork, communicate directly, and handle confidential information sensitively • Identify problems, seek solutions, and contribute to quality-improvement and customer-service monitoring efforts • Report directly to the Compliance Officer

🎯 Requirements

• Bachelor’s degree or higher in health information management, healthcare administration, nursing, or related field • 2–5 years of provider coding and billing experience in professional services • Experience auditing Evaluation and Management (E/M) services • Experience auditing CPT coding • Experience auditing ICD-10-CM diagnosis coding • Experience auditing HCPCS Level II coding • Experience auditing modifier usage • Experience auditing Medicare and commercial payer requirements • Experience auditing documentation requirements supporting billed services • Extensive knowledge of healthcare compliance policies, programs, practices, standards, and related compliance issues • Advanced knowledge of compliance and auditing principles, theories, and concepts • Knowledge of billing procedures and systems • Demonstrated experience and success with customer service principles with a varying group of people • Organizational, communication, and complex problem-solving skills • Experience with computers and application software • Ability to work independently and with minimal direction • Ability to work efficiently and flexibly in high-stress and fast-paced situations • Ability to participate as a collaborative team member • Ability to maintain confidentiality of MFB Health records and systems • Auditing, Compliance, Healthcare billing and/or coding certification preferred

🏖️ Benefits

• Remote work within the United States • Limited duration role covering a leave of absence • Reasonable accommodation for qualified applicants or employees with disabilities • Equal opportunity employment

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