Medical Auditor - Revenue Cycle Management

We are seeking an experienced, Full-Time Auditor to join our Revenue Cycle Management Team!

This is a 100% remote position requiring work hours of 8:00 am to 4:30 pm Eastern Time

Revenue Cycle team members must provide their own computer equipment.

The equipment must run the Windows 11 operating system and must run Office/Outlook 365.

Pay range starts at $22 per hour and increases commensurate with experience

Application Deadline: May 31, 2024

Advanced Recovery Systems is an integrated behavioral healthcare management company dedicated to the treatment of addiction, substance abuse, and mental health issues.  We put behavioral health front and center, providing assistance to people with substance abuse issues, addictions and mental health concerns.

With facilities in various regions of the U.S., we have been furthering this mission since our inception, applying our advanced approach to patient care.

Every facility in the Advanced Recovery Systems network strives to provide the highest quality of care, using evidence-based therapeutic models that really work. Our goal is to help men, women and adolescents live healthy, happy lives without the burden of substance abuse or mental illness.

The Revenue Cycle Team Auditor is responsible for coordinating daily, weekly, and monthly audits of revenue cycle denials to ensure all processes are designed appropriately and operating effectively and efficiently. The Denials Auditor will be focused on the root cause of denials and areas where process improvement is needed. These audits will require a complete knowledge of ARS’ EMR and Billing Systems, Compliance/Regulatory guidelines, and understanding the flow of data from the beginning of the revenue cycle to the end.

The Revenue Cycle Team Auditor Performs data analysis to support audit approach and to subsequently assess audit impact; review data for unusual transactions or trends such as, but not limited to; loss charges, claims not billed, no follow up on submitted claim, and denial posting, or adjustment errors. This position will perform appropriate research surrounding compliance regulations, billing best practice, account receivable follow-up standards, cash management protocols, and apply those tests to the audit. Perform root-cause analysis of significant denials trends identified. Provide clear directions and priorities, clarify roles and responsibilities, and facilitate effective communication throughout the project. Identify and clearly document denials audit issues and implications, consider root-causes and support conclusions. Identify and communicate issues raised, offering recommended solutions relevant to the project, business, and risk. Prepare the audit report and communicate to management on deficiencies and risks identified.

CORE JOB DUTIES:

1. Provide feedback to management and training to staff regarding audit documentation reviewed.
2. Perform control audits for revenue cycle functions to ensure controls are designed appropriately and operating effectively and efficiently.
3. Perform audits ensuring compliance with applicable regulations and established policies and procedures are being followed
4. Perform weekly and monthly routine review of audit outcomes with management of assigned projects.
5. Identify additional process improvement opportunities and assist in the redesign of those processes.
6. Review policies and procedures for various revenue cycle functions. Provide timely and appropriate feedback to departmental management regarding policies and procedures.
7. Document revenue cycle process memorandums and control matrices accurately and thoroughly.
8. Apply standard improvement processes and follow-up through (PDCA) Plan, Do, Check and Act
9. Create and report analysis of KPI data to senior management.
10. Maintain strict confidentiality; adhere to all HIPAA guidelines and regulations.
11. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks.
12. Participates in professional societies.
13. Follows all state regulations for development regarding professional license.
14. Other duties as Assigned

EDUCATION & REQUIREMENTS:

• Associates degree REQUIRED
  • Bachelors degree preferred
  • Experience in specific job function maybe substituted for education.
• Minimum five (5) years’ of experience in medical business matters at the client or physician practice level REQUIRED
• Lean Six Sigma, Kaizen or other Lean Process Management experience preferred.
• CPC, CPAM and/or RHIT preferred but not required.

We offer great benefits including 401(k), paid time off plan, medical, dental, vision, and much more.

BENEFITS:

• Pay: Competitive salary
• Paid Time Off: Up to 3 weeks of paid time off per year
• Retirement: 401K + match
• Insurance: Health, Vision, Dental, Life Insurance.  PLUS Teladoc access and visits at NO cost to the employee.
• Matching HSA -up to $1500 a year contribution from the company to your HSA.

Advanced Recovery Systems, a national integrated behavior healthcare management company dedicated to the treatment of addiction, substance abuse, eating disorders and mental health issues.  We invite you to learn more about us at our website! 

The Company complies with state and federal nondiscrimination laws and policies that prohibit discrimination based on age, color, disability, national origin, race, religion, or sex. It is unlawful to retaliate against individuals or groups based on the basis of their participation in a complaint of discrimination or on the basis of their opposition to discriminatory practices/EEO

We are proud to be a drug-free workplace.

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