Assistant Quality Auditor For Outpatient Billing

Shift:General Shift ( 9 a.m. to 6 p.m.)

Work Mode:In Office.

Thoroughly review medical records and billing data to identify discrepancies and errors in coding, claims, and reimbursement.

Ensure compliance with regulatory standards, coding guidelines, and payer policies.

Familiarity with medical terminology and clinical documentation.

Assesses the assigned diagnostic and procedural codes in the selected records. They check if the codes accurately reflect the documented healthcare services and if they comply with coding guidelines (such as ICD-10, CPT).

Identify areas for improvement in billing processes to enhance revenue collection and reduce denials.

Analyze data to identify trends, patterns, and potential issues in billing practices.

Knowledge of payer policies, Medicare regulations, and other relevant regulations.

Ability to analyze data, identify trends, and draw conclusions.

Ability to communicate effectively with billing staff, healthcare providers, and other stakeholders.

Ability to identify and resolve billing discrepancies and errors.

Proficiency with medical billing software and other relevant software applications.

Prepare audit reports, provide feedback to staff, and offer recommendations for corrective action.

Educate and train billing staff and healthcare providers on coding, billing, and regulatory changes.

Identify and mitigate risks related to billing fraud, compliance, and revenue loss.

Stay current on billing regulations, payer policies, and medical coding updates.

PREFERRED CANDIDATE PROFILE:

Any graduate or Postgraduate degree.

Minimum of 5 years of experience in medical billing, with a strong understanding of US healthcare billing practices and regulations.

Basic knowledge in medical coding.

Demonstrated ability to develop and deliver effective training programs.

Excellent communication skills, both written and verbal, with the ability to provide clear and concise instructions and explanations to team members.

Attention to detail and a commitment to accuracy and efficiency.

Strong analytical and critical thinking skills.

Proficiency in medical billing software and systems.

Ability to work effectively in a fast-paced and dynamic environment.

Ability to work under minimum supervision and demonstrate strong initiative.

Willing to work extended hours.