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About the role
Key responsibilities & impact- Audit daily work completed by billing staff, including claim submissions, follow-up activities, and collection efforts
- Review account documentation, actions taken, and billing outcomes within the billing system for accuracy, completeness, and compliance
- Identify errors, discrepancies, and trends affecting reimbursement, operational efficiency, or regulatory compliance
- Provide audit findings, feedback, and recommendations to billing staff and leadership
- Monitor, address, and audit special projects and programs, including credit card chargebacks, high-priority payer follow-up, and AB75
- Collaborate with team leads, supervisors, and managers to develop and refine policies, procedures, and workflows
- Assist with staff training on documentation standards, payer requirements, billing procedures, and industry best practices
- Participate in quality assurance initiatives and prepare reports for leadership
- Maintain current knowledge of industry regulations, payer policies, and billing software updates
- Support internal and external audit requests by gathering documentation, performing reviews, and responding to inquiries
- Perform manual tasks within Cross Workflow, including AR Support Requests and AR Follow-Up Requests
- Address high-priority Patient Services emails concerning invoices involving legal representation and time-sensitive deadlines
- Conduct compliance audits as assigned or requested
Requirements
What you’ll need- Ability to work in a fast-paced environment while maintaining accuracy and focus
- Strong organizational skills to ensure deadlines are met
- Strong knowledge of medical billing and accounts receivable processes, including claim lifecycle, denials, and payer rules
- Proficient in using billing software and electronic health record (EHR) systems
- High attention to detail and accuracy in reviewing documentation and financial records
- Analytical skills with the ability to detect patterns, discrepancies, and areas for improvement
- Understanding and adhering to HIPAA and other government and healthcare industry regulations
- Strong written and verbal communication skills to provide constructive feedback and report findings
- Ability to work independently, manage multiple tasks, and prioritize responsibilities effectively
- Extensive knowledge of insurance guidelines including Medicare and other government payers, private, self-insurance, and managed-care plans
- Familiarity with auditing techniques and principles within a healthcare revenue cycle setting
- Knowledge of MS Office including Outlook, Word and Excel
- Excellent verbal and written communication skills
- Excellent attention to detail and time management skills
- Excellent customer service skills
- High School Diploma
- Minimum 3-4 years revenue cycle experience