Melville,NY - USA

Position Requirements

RESPONSIBILITIES

• Prepare and review Audit Reconciliation reports to validate the accuracy of case volumes, and identify, reconcile, and post missed cases to ensure revenue capture.
• Conduct a pre-posting review of records on any missed cases identified during the Missing doc process, audit tracking, and Focused and Quality audits. Post any missed cases found during the Audit tracking process or identified during the Revenue Recovery audits.
• Track and trend compliance within the Missing Documentation Process utilizing scenarios to identify and quantify breakdowns in the process.
• Collaborate with cross-functional teams to complete posting and submit corrections in a timely manner
• Perform pre-correction reviews of charge corrections to ensure the accuracy and adherence to payer guidelines and NAPA policies, avoiding any risk to revenue collected.
• Perform corrections in the billing system to ensure compliance with respective payer requirements.
• Analyzing payer claim acknowledgment rejections collaboratively with the Accounts Receivable (A/R) department to identify root causes, implement corrective actions, and ensure timely and accurate claims processing and payment.
• Act as the escalation point for fast-tracking and resolving late charges in the billing system, for cases that are external to the standard RCM workflows. Tasks include uploading documents, verifying coding, conducting eligibility checks, data entry, calculating concurrency, and final posting for timely resolution.
• Assist Revenue Integrity leadership with special projects and other ad-hoc tasks.
• Research and stay current with payer requirements, specifically in the context of anesthesia billing.

REQUIRED QUALIFICATIONS

• Minimum 3 years of Medical Billing experience
• CPC or equivalent is required or must be obtained within 1 year.
• Proficiency in auditing and data analysis specific to medical billing and revenue reconciliation.
• Understanding of Revenue Cycle Management, payer policies, and HIPAA Compliance
• Proficient in document management systems, EMRs, and medical billing systems.
• Strong computer skills, including Office 365
• Ability to multitask and give attention to detail.
• Ability to work independently and as an integral part of the team.
• Exceptional organizational and time management skills.
• Effective communication skills, both verbally and in written text.

PREFERRED QUALIFICATIONS

• Associate degree preferred.
• Experience in Anesthesia billing,
• Experience in A/R

TOTAL REWARDS:

• 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

The Revenue Reconciliation Auditor plays a crucial role in ensuring the reconciling of billed anesthesia cases with actual cases performed by NAPA providers. This involves independently managing multiple tasks, such as identifying scheduling issues, missed cases, and workflow breakdowns and inconsistencies. Under the supervision of the Audit Manager and Senior Auditor, the role requires the posting of missed cases, charge correction, and a detailed reconciliation review of scheduled cases. A thorough understanding of payer claim processing and familiarity with Front-end business services and Accounts Receivable workflows is essential for this position.

EEO Statement

North American Partners in Anesthesia is an equal opportunity employer.