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Scope of Position
The Revenue Integrity Auditor will work with the Charge Description Master (CDM) unit to ensure the overall integrity of the CDM by maintaining a focus on accuracy, revenue cycle integrity, and compliance with third-party requirements. The Revenue Integrity Auditor processes accounts and charges via Work Queues within Epic to ensure accounts/charges move through the system timely to aid in cash flow. Provides support and services to Revenue Cycle, Financial Services, Information Technology Systems, Medical Information Management, and all clinical departments.
The Revenue Integrity Auditor is responsible for auditing charge processes and procedures throughout the organization to maintain charge integrity in compliance with CMS and other regulatory agencies. Responsible for maintaining current knowledge of the various regulatory agency guidelines and assure requirements are met along with accurate, complete and timely charge processes. Responsible for auditing current charge processes and, as needed, identifying correct charge processes. In addition, this position will assist in developing staff training materials to assure accurate charge processes are implemented and maintained.
Position Summary
The Revenue Integrity Auditor is responsible for monitoring, analyzing, and facilitating the entry of service and supply fees into various information systems. Ensure that charge capture applications are accurate and compliance standards are maintained. The Revenue Integrity Auditor will work with all cost centers and OSUP representatives to ensure the timeliness and accuracy of charge capture accuracy. This position will research, implement, and audit the use of tools such as Epic’s charge router, facility charge calculator and charge by documentation.
Minimum Qualifications
For Hire:
Required:
Bachelor degree in Business, HIM, or related field, or equivalent combination of experience and education.
Required License/Registration/Certification: RHIA, RHIT, CCS and/or COC credentials.
Certification Requirement: Must obtain EPIC Resolute Hospital Billing Charging certification within the first 6 months of employment. Support and resources will be provided to assist in achieving this requirement.
Minimum of two years of hospital clinical coding experience required; understand and interpret medical records, hospital bills, and the charge master.
Proficiency in hospital and clinical record information systems and inpatient and outpatient coding methodologies.
Knowledge and understanding of insurance terms (i.e. EOB, Stop Loss, etc.) and reimbursement methodologies.
Understanding of revenue cycle functions, management and reporting in health care, and an overall operational knowledge of how those functions and activities of hospitals and medical clinics impact reporting.
Foster a collaborative and team focused working environment.
Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.
Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions.
The university is an equal opportunity employer, including veterans and disability.
As required by Ohio Revised Code section 3345.0216, Ohio State will: educate students by means of free, open and rigorous intellectual inquiry to seek the truth; equip students with the opportunity to develop intellectual skills to reach their own, informed conclusions; not require, favor, disfavor or prohibit speech or lawful assembly; create a community dedicated to an ethic of civil and free inquiry, which respects the autonomy of each member, supports individual capacities for growth and tolerates differences in opinion; treat all faculty, staff and students as individuals, hold them to equal standards and provide equality of opportunity with regard to race, ethnicity, religion, sex, sexual orientation, gender identity or gender expression.