Clinical Charge Auditor
|Title:||Clinical Charge Auditor |
|Location :||Oakland, CA|
Proficient in all areas of Clinical Charge Audit and Revenue Cycle
as it relates to identification of accurate documentation and billing; based on compliance to government regulations, relying on clinical knowledge and experience.
Essential Duties and Responsibilities:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
- Work as a project manager, team leader, team member of the project team, or independently as project dictates.
- Communicate to management the progress of assigned project.
- Provide complete and accurate management reports to client as directed by supervisor.
- Verbal and written communication to all client levels as instructed by management.
- Consultation and recommendations on development of client charge related Protocol, Policies, and Procedures.
- Training of Charge Audit personnel utilizing advanced knowledge of government regulations & guidelines.
- Maintain a professional appearance and demeanor at all times.
- Abide by all hospital policies and guidelines including participation at client required orientation, safety, and HIPAA related education.
- Work harmoniously with client and NHR personnel .
- Maintain privacy of patient information as outlined by HIPAA guidelines.
- Extensive travel may be required.
- Work at any facility where assigned and change of assignment at company discretion.
- Accurately enter hours worked on a daily basis for client billing purposes into NHR web based system.
- Other duties as assigned.
Builds customer confidence, is committed to increasing customer satisfaction, sets achievable customer expectations, assumes responsibility for solving customer problems, ensures commitment to customers are met, solicits opinions and ideas from customers.
Meets commitments, works independently, accepts accountability, handles change, sets personal standards, stays focused under pressure, meets attendance/punctuality requirements.
Deals with others in a straightforward and honest manner, is accountable for actions, maintains confidentiality, supports company values, convey good news and bad.
Understands duties and responsibilities, has necessary job knowledge, has necessary technical skills, understands company mission/values, keeps job knowledge current, is in command of critical issues.
Manages a fair workload, volunteers for additional work, prioritizes tasks, develop good work procedures, manage time well, handle information flow.
Is attentive to detail and accuracy, is committed to excellence, looks for improvements continuously, monitors quality levels, finds root cause of quality problems, owns/acts on quality problems.
Meets all team deadlines and responsibilities, listens to others and values opinions, helps team leader to meet goals, welcomes newcomers and promotes a team atmosphere.
The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Bachelor's degree (B. A.) from four-year college or university in Nursing or Hospital Administration; or five years related experience and/or training; or equivalent combination of education and experience. Coding, Compliance and Case Management experience preferred. Experience in hospital revenue cycle, electronic health plus.
Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community. Ability to write articles for publication that conform to prescribed style and format.
Ability to work with mathematical concepts such as probability and statistical analysis. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
Knowledge of Microsoft Office applications including Word, Excel, Outlook, Powerpoint, PFS Software, Epic, and Internet Research
Certificates and Licenses:
LPN and LVN preferred
Supervises project team of 1 to 5 employees. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Assist manager in interviewing and hiring process. Provide training to employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee may occasionally be exposed to outdoor weather conditions while traveling. The noise level in the work environment is usually moderate.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The employee must frequently lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus. While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is frequently required to reach with hands and arms. The employee is occasionally required to stand; walk; climb or balance and stoop, kneel, crouch, or crawl.
This opening is closed and is no longer accepting applications