Tri-County Human Services, Inc.

Auditor

• Review service documentation and provide technical assistance and expertise related to private insurance, ADM, CFBHN, and Medicaid
• Review randomly selected electronic health records to determine effective utilization and quality management of services
• Enter audit results into the electronic health record system for tracking and analysis
• Coordinate with staff completing documentation and data entry to coordinate billing and ensure compliance with agency policy
• Review clinical records to identify billable services that do not meet insurance documentation requirements
• Advise Program Supervisors and unit staff regarding billing opportunities, missed opportunities, and required documentation
• Provide audit findings to facility supervisors and administrative staff and follow up on corrections
• Maintain current knowledge of Medicaid, PPWDC, TANF, FIS, CFBHN, and private insurance documentation and billing requirements
• Provide ongoing education to staff regarding documentation standards and guidelines
• Train assigned support staff on billing and audit procedures
• Recommend follow-up actions, including potential disciplinary action, in consultation with the Compliance Director
• Assist the compliance department with reviewing, developing, and updating policies and procedures
• Perform other assigned duties

Internal Auditor