Shift: Monday - Friday, Hours: Flexible Start Time
Set your sights on a role making a real difference in the healthcare system. We’re looking for a self-motivated Clinical Charge Auditor to join our team. We have a relentless focus on driving results for our customers and enabling them to invest more into patient care; in turn, this allows us to continue to grow our company and your career.
The Clinical Charge Auditor is responsible for coordinating and facilitating clinical functions required for the patient account functions. This person will review medical record documentation to determine whether services charged were provided and support by the medical record and that the correct services were charged. This person serves as a consultant to the charge capture and billing functions to provide a secondary review of the claims identified as missing, duplicate or incorrect charges. The position assists coders with clinical documentation issues and serves as a liaison between charging and billing staff. The Clinical Auditor will defend or support charges through third party
The successful candidate must have demonstrated track record performing charge and billing audits.
Your day to day role will include:
Coordinates and facilitates clinical functions required for the patient accounting functions
Reviews medical record documentation to determine services charged were provided and supported
Works effectively with charge capture and billing functions as a secondary review of claims
Performs charge audits periodically to support corporate compliance program
Assists coders with clinical documentation issues and works as a liaison for charging and billing staff
Reviews and separates charge before billing for split insurance coverage
Identifies process improvements for revenue cycle staff operations team
Defends or supports charges disputed by third party payer audits
High School diploma or equivalent.
Registered nurse with current license (RN) or other high level clinical technician licensure; such as respiratory therapist, physical therapist, pharmacy technician, or medical assistant or radiology technician with audit experience
Knowledge of clinical documentation processes and procedures
Knowledge of medical terminology
Experience with Microsoft office software products
Excellent time management and attention to detail
Ability to communicate well orally or written.
It would be great if you also have:
Bachelor Degree or coding certification preferred
Electronic medical record experience
R1 is changing healthcare by infusing operational discipline and proprietary technology in hospital financial processes. We are an industry leader; we are the only independent organization with a comprehensive service and technology offering for hospital revenue cycle management, and we have achieved leading outcomes for our customers.
- A strong financial performing, growing organization that will keep you on your toes with new ideas, changes and opportunities to learn and grow in abundance.
- A culture of excellence, driving customer success so they can focus on improving patient care and on giving back to the community.
- A Total Rewards package which may include such things as: competitive compensation package, the ability to choose from a comprehensive benefit program mostly funded by R1 that includes medical, dental, vision, flexible spending accounts, commuter benefits, life and disability insurance, along with work life balance programs including paid time off for personal time, illness and volunteering, and we offer a retirement savings plan and continuing training and development and so much more!
Sound like you? Let’s talk!
R1 is a leading provider of revenue cycle management services and Physician Advisory Services to healthcare providers. We are the largest independent end-to-end revenue cycle provider and have the longest operating history in the revenue cycle industry. R1’s objective is to be the one trusted partner to manage revenue so providers and
patients can focus on what matters most. Our distinctive operating model and values includes people, processes, and sophisticated integrated technology/analytics that help customers realize
sustainable improvements in their operating margins and improve the
satisfaction of their patients, physicians, and staff. We are dedicated to transforming the commercial infrastructure and patient experience