
Healthcare Compliance and Auditing Lead
2 days ago
The position of Auditor Specialist for Revenue Cycle Management (RCM) requires a highly skilled individual to oversee the auditing processes within medical billing and credentialing functions.
Key Responsibilities:
- Audit Planning and Execution: Conduct regular audits on charge entries, payment postings, and claim submissions to ensure compliance with industry standards and company policies.
- Compliance and Regulatory Adherence: Monitor adherence to payer-specific billing rules and government regulations, and stay updated on changes in healthcare laws.
- Consulting and Mentorship: Provide consulting services and lead independent audits and assessments to improve operations and manage risks related to complex technology and processes.
- Performance Analysis and Reporting: Prepare and deliver KPI & MTD reports to track performance and resolve discrepancies.
- Follow-up and Remediation: Implement corrective action plans based on audit outcomes to enhance overall compliance and financial performance.
Required Skills and Qualifications:
Candidates should have a strong analytical and organizational skillset, with excellent communication and leadership abilities.
Desirable skills include proficiency in billing and auditing software tools, knowledge of ISO standards, and certification in Medical Billing/Coding, RCM, or relevant certifications.
Benefits:
We offer a range of benefits, including paid leaves, HR bonus, loan policy, advance salary, yearly loyalty rewards, performance-based bonuses, leave encashment, inflation bonus, promotion, increments, and more.
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