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Franciscan Missionaries of Our Lady Health System
Franciscan Missionaries of Our Lady Health System
Sponsor pentru viza H1BAsistență medicalăImpact socialNonprofit
Franciscan Missionaries of Our Lady Health System este o organizație catolică mare, nonprofit, de asistență medicală, care deservește comunități din Louisiana și din zona metropolitană extinsă a statului Mississippi. Rețeaua sa de servicii medicale include spitale, clinici și medici care oferă o gamă largă de servicii de sănătate, concentrându-se pe îngrijirea pacienților, sănătatea comunității și educație. Cu sediul în Baton Rouge, Louisiana, organizația reunește o forță de muncă numeroasă din domeniul medical, dedicată îngrijirii pacienților și îmbunătățirii rezultatelor de sănătate în întreaga regiune.
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Locurile de muncă ale companiei

Reimbursement Auditor, Louisiana (Remote)

Conduct remote audits of hospital coding, claims, medical records, and charges. Support regulatory compliance, accurate reimbursement, billing resolution, and revenue-cycle improvement.

USStatele Unite ale AmericiiLALouisianaRemoteNormă întreagăNivel mediuSeniorLimbă Obligatorie: englezăAuditor

Descriere

  • Audit Charge Master-driven and HIM-assigned codes and medical-record documentation against itemized charges and facility-assigned codes for government and non-government accounts.
  • Correct inaccurate items and services.
  • Help resolve billing edits and provide coverage guidance for billable services.
  • Monitor the Federal Register, Medicare and Fiscal Intermediary transmittals, bulletins, memorandums, NCD, LCD/LMRP, OCE, and CCI edit-management resources.
  • Inform designated hospital team members about current and forthcoming APC and other government-program regulations.
  • Deliver twice-yearly training for designated hospital staff and provide education to revenue-producing and ancillary departments as needed.
  • Review CMS, Medicare, and Medicaid bulletins and implement internal updates that support coding and charge-practice compliance.
  • Record monthly findings and recommend actions to prevent recurring billing issues and advance process-improvement initiatives.
  • Help reduce bill rejections and payment delays arising from coding and billing practices.
  • Prepare reports covering process-improvement recommendations and systemic claim-processing issues.
  • Audit medical records to verify that services are accurately represented on itemized statements and related documentation.
  • Evaluate selected retrospective claims and records for accuracy and defend facility charging and coding practices during focused audits.
  • Identify APC-related coding and billing issues and verify outpatient claims use the correct CPT-4 and HCPCS Level II codes.
  • Analyze how changes to the Charge Description Master and billing practices affect revenue.
  • Complete other assigned duties.

Cerințe

  • At least three years of experience.
  • Associate degree in Nursing or Health Information Management.
  • Proficiency with payment review systems, payment methodologies, and insurance terminology.
  • Ability to synthesize and evaluate data.
  • In-depth knowledge of ICD-9-CM, HCPCS, and CPT-4 nomenclature, codes, and guidelines.
  • Proficiency with 3M coding software.
  • Current RHIT or LPN license.

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