Professional Auditor for RCM
6 days ago
This position involves overseeing the auditing processes within the revenue cycle management function. The ideal candidate will have a strong background in medical billing and credentialing processes, as well as experience in auditing and quality management.
**Responsibilities Include:**
- Developing and implementing comprehensive audit plans for medical billing and credentialing processes.
- Conducting regular audits on charge entries, payment postings, and claim submissions to ensure compliance with industry standards and company policies.
- Mentoring team members, providing consulting services, and managing risks to enhance the RCM process.
- Providing detailed reports on audit outcomes to senior management, outlining key performance indicators (KPIs), compliance issues, and recommendations for improvement.
- Ensuring strict compliance and best practices in billing and credentialing to identify and mitigate risks associated with the revenue cycle.
Qualifications Include:
- Bachelor's degree in Healthcare Administration, Business Administration, Finance, or a related field.
- Certification in Medical Billing/Coding, RCM, or relevant certifications (e.g., CPC, CPMA).
- 5+ years of experience in medical billing, credentialing, and RCM auditing, with leadership experience preferred.
- Minimum 5 years of full-time working experience in auditing or quality management in RCM or healthcare.
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