Allegheny Health Network
Job Description :
Concurrent and retrospective audits of patient records to assure proper charging of services for compliance and proper reimbursement of claims. Provide information/education (act as resource) for clinical departments in maintaining appropriate charging patterns.
- Audit patient medical records and other source documents charges to assure completeness and accuracy of charges on patient bill. (50%)
- Assist in educating departments on charging and documentation issues. (10%)
- Work as a liaison between PFS, medical record/coding, and ancillary departments to expedite resolve of edits. (10%)
- Enter audit findings in database for reporting. (10%)
- Assist in identifying process breakdown between departments in the transfer of charge codes. (10%)
- Integrates performance improvement principles into all aspects of job responsibilities. (5%)
- Integrates customer service excellence principles into all aspects of job responsibilities. (5%)
- Other duties as assigned.
- Associate's Degree
- Medical Terminology
- Bachelor’s Degree
- EPIC experience
- Over 2 years’ experience in coding, billing or charge auditing
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
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