Healthcare Documentation Auditor
BASF
full-time
Posted on:
Location Type: Remote
Location: United States
Visit company websiteExplore more
Salary
💰 $19 - $21 per hour
About the role
- Review medical records for services billed and validate required documents and information is contained within the records submitted for various service types as required by clients.
- Applying local coverage determination (LCD), national coverage determination (NCD), and commercial payer policy to services in review
- Document and articulate review findings and reference the appropriate policies and rules in the audit platform and as rationale language.
- Working collaboratively with the audit team to identify vulnerabilities and/or cases subject to potential abuse.
- Keep abreast of changes in technology and regulatory issues that may affect our business and clients.
- Suggest ideas that may improve audit workflows.
- Participate in the development of Review Guidelines and meetings as necessary.
- Cross-train in other audit types/focus areas or management teams as applicable
- Maintain required quality and productivity standards.
- Performs other duties as assigned.
Requirements
- High School Diploma or GED is required
- Some college is preferred
- At least two years’ experience in adjudicating/examining claims for a Commercial Insurance Company, Tricare, MAC, or organizations performing similar functions, preferred
- At least five years’ experience of provider professional billing, coding, and documentation practices in an outpatient setting, DME, home health, infusion, or hospice to Commercial Insurance Companies, Medicare, Medicaid, Tricare, or organizations performing similar functions, highly desirable
- Familiarity in quality assurance for internal compliance of billing practices
- Clerical experience dealing with any aspect of: ICD-10, CPT-4 or HCPCS coding
- Experience using Microsoft Excel and other Microsoft Office applications.
Benefits
- 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
ICD-10CPT-4HCPCS codingbilling practicesdocumentation practicesquality assuranceadjudicating claimsprovider professional billingcodingaudit workflows
Soft Skills
collaborationcommunicationattention to detailproblem-solvingorganizational skillssuggestive thinkingadaptabilityteamworkanalytical skillstime management
Certifications
High School DiplomaGED