Job Title: RCM Audit/Training Specialist
Status: Full Time
Reports to: VP, Revenue Cycle
Work Place: Remote with occasional travel
Job Details:
Under the general direction of the VP, Revenue Cycle, the RCM Audit Specialist facilitates the review of medical claim submission in accordance with state, federal, and payer guidelines to ensure best-in-class services to the patients of CSI Pharmacy.
Responsibilities
-
Effectively prioritize and complete all assigned tasks.
-
Complete commercial and government payer audits in a timely manner.
-
Perform a percentage of quality audits on a pre and post bill basis.
-
Perform review on all government denials due to billing errors.
-
Implement audit approaches including scope and statistical sampling methodologies.
-
Develop and implement training and education for billing, collection and credit management teams.
-
Ongoing employee training and assessment reviews collaborating with management to achieve set goals and objectives.
-
Effectively prioritize and complete all assigned tasks.
-
Performs in accordance with system-wide competencies/behaviors.
-
Other duties as assigned by Management.
Qualifications
-
Bachelor's Degree or 4 years of equivalent work experience in a home infusion or specialty infusion business environment required.
-
Strong working knowledge about compliance and regulatory guidelines including but not limited to an awareness of trending federal audit targets based on claim errors.
-
Ability to work effectively with colleagues as team members and to communicate effectively.
-
Self-motivator and able to work independently.
-
Competence in Microsoft Office products.
-
Working knowledge of basic medical terminology is required.
-
Excellent verbal and written communication skills.
-
Strong customer service orientation.
-
Competence in Microsoft Office required, including Excel, Access, and Word.
-
Must possess strong interpersonal and organizational skills, with the ability to work on multiple tasks simultaneously.
NOTICE: Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana.
By supplying your phone number, you agree to receive communication via phone or text.
By submitting your application, you are confirming that you are legally authorized to work in the United States.
JR# JR239509