Auditor, Recovering Audit Contractor

Location
Virginia Beach, VA
Salary
Competitive
Posted
Nov 05, 2018
Closes
Mar 28, 2019
Ref
114051BR
Function
Administrative
Industry
Healthcare
Hours
Full Time
Overview:

Sentara Healthcare is hiring an Auditor, RAC (Remote or On-Site)

Shift: Full Time, Days


Did you know there are exciting opportunities for remote hire/work for this position if you are a resident of the following states?WashingtonSouth DakotaVirginiaNorth CarolinaWyomingTexasNevada FloridaHave you been looking for a position where you can put all of your education and coding skills to use while being able to work remotely from home at the same time?

We may not be right next door, but to join our team--you only have to go as far as your living room!

We are a leading not-for-profit Healthcare system that is looking for talented, dedicated healthcare professionals like yourself. For more information about these exciting remote and on-site opportunities, please email tmsinger@sentara.com or complete an application online today!




Sentara Benefits:

Sentara employees strive to make our communities healthier places to live. We’re setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For more information about our employee benefits, CLICK HERE!

Join our team, where we are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, growth!


Other
Associates in HIM or 2 years in lieu of degree or Bachelor's In HIM degree or 4 years experience in lieu of degree required. Ability to understand and interpret medical records, hospital bills and ChargeMaster. Must demonstrate an understanding of Medicare and other payer guidelines related to billing and charging of observation services, other separately chargeable services, and other lines of service. Must demonstrate knowledge of managed care contracting arrangements as well as notification and clinical review requirements. Must also be knowledgeable of regulatory and compliance requirements for government payers regarding clinical reviews and medical necessity. Previous Healthcare Auditing experience preferred

Responsibilities:

The Recovery Audit Contractor (RAC) Auditor is responsible for determining that the ICD 9, ICD 10 and CPT coding is supported by the clinical documentation in the medical record. Must be a proficient coder with thorough knowledge of coding guidelines and coding clinics. Primary function is the ability to write a complete comprehensive appeal to support claims coded appropriately. Also performs a number of functions including those of internal auditing, coder education, physician documentation education, liaison with external auditors for corporate audits.

Qualifications:

Education Level
Associate's Level Degree - HEALTH INFORMATION MANAGEMENT - Experience in lieu of education: Yes OR
Bachelor's Level Degree - HEALTH INFORMATION MANAGEMENT - Experience in lieu of education: Yes

Experience
Required: Coding - 5 years

Preferred: None, unless noted in the "Other" section below

License
Required: Cert Coding Specialist, Cert Professional Coder

Preferred: None, unless noted in the "Other" section below

Skills
Required: Communication, Coordination, Critical Thinking, Microsoft Office, Monitoring, Reading Comprehension, Service Orientation, Technology/Computer, Writing

Preferred: None, unless noted in the "Other" section below

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