Medical Billing & Coding Auditor-HYBRID-FT

A comprehensive human services organization is seeking a Full-time Medical Billing & Coding Auditor to be a vital part in furthering its mission.  As an essential part of the everyday operations of the agency, the Medical Billing and Coding Auditor will be responsible for working with Mental Health Department staff and other JCS interdepartmental staff to ensure documentation compliance and review of revenue cycle management under federal and state standards and funder requirements.  This position will ensure the accurate and timely reporting of billing information and ensure required compliance standards are met. As a vital member of this team, the successful candidate will have a range of experience and education to be the subject matter expert in Medical Billing and Coding and an exceptional attention to detail.

This is a hybrid work opportunity.

Responsibilities:

  • Auditing CMS & or Commercial Insurance billing for diagnosis data collected from records (collection and analysis coding and reimbursement guidelines)
  • Reviewing records to determine the accuracy of coding, billing and supporting clinical documentation from JCS providers.
  • Maintaining current knowledge of requirements and guidance required in the performance of audit duties, including but not limited to ICD10, CMS, insurance, state, and federal regulations
  • Ensure all EHR entries are accurate.
  • Ensure all federal, State, and other compliance standards are met and followed.
  • Evaluate current Billing and Coding processes and suggest improvements that ensure accuracy and efficiency.
  • Coordinate with various JCS personnel to improve current documentation, billing, and coding processes.
  • Provide education, training and direction to providers, clinical support staff and billing staff regarding documentation and coding requirements to support a compliant and accurate billing practice
  • Review and maintain the billing service description master, including bill code assignment in accordance with regulatory and third-party payer guidelines
  • Maintain current and in-depth knowledge of government and third-party payer billing regulations and guidelines
  • Facilitate the improvement in coding and clinical documentation practices that support appropriate billing and reimbursement for the level of service rendered
  • Work under the supervision of internal staff and designated lead to achieve goals and ensuring project progress.
  • Reviews require data analysis and research within data systems.  Reports finding to supervisor.
  • Reviews require data analysis and research within data systems
  • Review records that have been reviewed and coded for accuracy and educate term regarding denials and improvement opportunities.

Requirements:

  • BS/BA with a minimum of five years of related work experience including but not limited to claims
  • 3-5 Years in a position of similar responsibilities related to medical claims and identification of coding inconsistencies in a behavioral healthcare space
  • Knowledge base to include extensive background in Medical Billing and Coding with Auditing responsibilities
  • 3 years of Coding experience in nonprofit and OMHC settings preferred

COVID VACCINATION AND PROOF OF VACCINATION REQUIRED

Pay:  DOE                                                                                           

Benefits: Benefit package included.

Schedule:  Full-time; Hybrid

 Zip code: 21215

Job ID: #10158MBCA

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