Job Description
The Revenue Integrity Auditor is responsible for auditing documentation and charges to ensure compliance with all State and Federal guidelines and regulations, and providing feedback to hospital charging departments on documentation, charges and charge master coding. The Auditor researches billing issues and prepares relevant educational materials.
The Auditor performs detailed Hospital, Ambulatory Surgery Center, and Outpatient Clinic Audits to ensure all charges have been captured and are supported by orders and appropriate documentation. Reviews audit findings with the Hospital, ASC, and Outpatient Clinic representatives and provides opportunity for a response and follows up on re-audits in a timely fashion to ensure that cases are completed. The Auditor performs special audits throughout the year as requested, provides executive summaries of all audit results to the appropriate departments, and demonstrates tact and understanding in handling problems.
The position also provides education based on billing and compliance issues identified and at the request of individual facilities, administration and management utilizing SHINE modules, webinars, PowerPoints, Bulletins, newsletter, etc as needed throughout the year. The Auditor researches billing issues and compliance concerns utilizing federal and state health-care related rules and regulations and major healthcare payor policies and guidelines in order to ensure compliance with the law. Position updates status of all cases assigned on minimum weekly basis and informs director of any changes, problems, or concerns that arise at a facility.
About Shriners Children’s
Shriners Children’s is an organization that respects, supports, and values each other and is engaged in providing excellence in patient care.