
Medical Billing and Auditing Expert
3 days ago
The Professional Auditor for RCM is responsible for overseeing the auditing processes within the medical billing and credentialing functions. Key Responsibilities include conducting detailed audits to ensure compliance with regulations, identifying areas for improvement, and implementing corrective actions to optimize revenue cycle performance.
**Key Areas of Focus:**
- Audit Planning and Execution:
- Compliance and Regulatory Adherence:
- Consulting and Mentorship:
- Performance Analysis and Reporting:
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.
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