Melville,NY - USA
Position Requirements
RESPONSIBILITIES
- Supports the Revenue Optimization Auditors and serves as the Subject Matter Expert (SME) in the day-to-day operations, ensuring departmental processes, policies, and procedures are understood and followed.
- Performs quarterly QA on the audit team, ensuring that all billing and coding practices adhere to federal, state, and local regulations, as well as industry standards like ICD-10, CPT, and HCPCS.
- Generate and present reports to management, including example records, highlighting audit findings, revenue trends, and compliance risks. Provide insights and recommendations for corrective actions.
- Utilize data analytics tools and techniques to analyze large datasets, identify patterns, and detect anomalies that may impact revenue integrity including over-coding, under-coding, and missed billing opportunities.
- Collaborate with staff, including Physicians, Auditors, and Coders, to provide training and education on revenue cycle best practices, coding guidelines, and documentation requirements.
- Promote a culture of continuous improvement within the Revenue Optimization Team and the organization, seeking opportunities to enhance revenue processes and outcomes.
- Train and support new hires through the onboarding process
- Coordinates and participates in team and management meetings.
REQUIRED QUALIFICATIONS
- Must have a minimum of 3 years as a CPC, and 1 additional certification (i.e. CPMA, CANPC, CDEO) and previous auditing experience.
- Demonstrate strong leadership and decision-making abilities.
- Strong background in process implementation and improvement
- Well-rounded knowledge of CMS requirements, claims processing, billing/coding guidelines, and the Revenue Cycle process (i.e. from document retrieval to claim submission)
- Extensive knowledge of medical billing software and Electronic Medical Records.
- Excellent verbal, written, and presentation skills
PREFERRED QUALIFICATIONS
- Some supervisory experience preferred
- Previous anesthesia billing experience preferred
- Knowledge of Revenue Cycle A/R, including denials management
- Experience in handling Payer Audits
Total Rewards
- Salary: $61,706.93-$84,847.03
- Generous benefits package, including:
- Paid Time Off
- Health, life, vision, dental, disability, and AD&D insurance
- Flexible Spending Accounts/Health Savings Accounts
- 401(k)
- Leadership and professional development opportunities
A Senior Auditor, Revenue Optimization plays a crucial role at NAPA, ensuring that billing practices and revenue capture processes are compliant with regulations and optimized for revenue generation.
This role is responsible for assisting the Manager, Revenue Optimization Audits in overseeing the day-to-day operations of the Revenue Optimization Audit Team. As Senior Auditor, this person will act as the first point of contact for the audit team members, by guiding the team in maximizing revenue through audits, education, and adherence to policies and procedures. This role requires an individual who is experienced in working in a fast-paced environment, can prioritize multiple projects, and can show and speak to the results of their efforts.
EEO Statement
North American Partners in Anesthesia is an equal opportunity employer.