Manager - Revenue Integrity Auditing

Chicago, IL
Operations
Full-time

Job Description:
 
Right now, we are looking for an outstanding, brilliant, and driven Manager of Auditing for Revenue Integrity to have a comprehensive understanding of medical terminology, coding, charge entry, insurance adjudication, contractual agreements, statements and collections. This role requires someone to be organized, detail-oriented, accurate, and professional and would, ideally, possess CPC certification and other coding credentials/clinical expertise.  In this role, the Manager must approach problem-solving challenges independently, have strong attention to detail and enjoy working in a fast-paced, collaborative team-based environment.     

Looking for some details?

    • Assign, manage, achieve, and maintain client financial performance targets
    • Effective leadership and management of audit staff
    • Perform financial analysis reviews for assigned clients and provide solutions to improve performance
    • Assist in prediction enhancements to increase verification rates
    • Work with internal and external stakeholders to achieve client goals and expectations
    • Participate in special project teams as needed as a representative for the charge audit business function

Do you fit our team?

    • Demonstrated Leadership & Management skills
    • Proven charge capture analytical and research skills in hospital charging practices, payer reimbursement methodology, medical necessity criteria, and applicable industry based standards
    • Remain current on CPT, ICD, HCPC and modifier coding requirements and payer requirements
    • Experience required with one or more of the following specialties: Interventional Radiology, Invasive Cardiology, General Surgery, Orthopedic Surgery, Vascular Surgery, and Surgical Oncology
    • Proficiency using Microsoft Office Suite products including Excel and PowerPoint
    • Ability to communicate effectively with a wide range of audiences such as Providers,        Managers, staff, and senior leadership
    • Demonstrate independent judgment, discretion, and decision making abilities
    • Self-motivated, hardworking individual with a high attention to detail
    • Quality control skills
    • Coaching, education, and training skills
    • Excellent organization skills
    • If remote, regular travel to the Chicago office will be required

    • Experience
    • 3+ years of hospital auditing/coding experience with CPT, ICD, HCPCS and modifier coding
    • 1+ years of auditing experience with a technology driven charge integrity solution preferred
    • Experience working within the hospital environment preferred

    • Education/Certification
    • Undergrad or Graduate degree in HIM or related field preferred
    • CPC or RHIT/RHIA preferred