Charge Audit Manager - Long Beach - Managed Resources

    Managed Resources
    Managed Resources Long Beach

    1 day ago

    Description

    Purpose

    The Charge Audit Manager is an exempt, full?time remote position. This role oversees staff, performs reviews and training, acts as the client liaison for all contracted services including defense audits, charge audits, medical necessity reviews and concurrent audits, manages staff hiring and performance, compiles and communicates findings both written and verbally, and provides educational services to improve revenue recovery and compliance.

    Reports to

    Vice President of Revenue Integrity

    Accountabilities

    • Maximize revenue recovery by consistently achieving accurate audits.
    • Demonstrate leadership in managing staff.
    • Provide continuing education for staff to promote development in knowledge.

    Essential Job Functions

    • Analyze workload and staffing needs; monitor and adjust on an ongoing basis.
    • Evaluate staffs performance in meeting the goals identified by the company and contract.
    • Approve staff payroll and monitor productivity levels of onsite and remote employees.
    • Hire, train, manage and issue performance reviews and improvement plans as needed.
    • Perform charge audits, defense audits, medical necessity reviews and physician billing audits as outlined in the contract.
    • Prepare periodic corporate reports on audit volume and results.
    • Perform quality assurance reviews on all employees.
    • Participate in hospital meetings, report audit findings and suggest improvements.
    • Design and provide education for hospital staff to improve revenue recovery and compliance.
    • Communicate effectively with project principals, MRI supervisor and hospital liaison.
    • Work with the client to obtain proper access and resources for staff to conduct audits.
    • Develop, review, and update audit policies and procedures.
    • Travel to client sites or corporate office may be required.

    Ideal Candidate

    • 10+ years of charge and defense audit experience preferred.
    • RN license required.
    • Prior experience as a Charge Audit Manager, remote environment is a plus.
    • CMAS certification is a plus.
    • Strong oral and written communication, problem?solving, and business management skills.
    • Knowledge of the health care industry and revenue cycle billing.
    • Profound analytical ability.
    • Computer proficiency in Microsoft Office (Word, Excel, PowerPoint, Access).
    • Ability to work independently in a fast?paced environment.
    • Ability to interact with management personnel.
    • High attention to detail, ability to multi?task, and meet multiple deadlines.
    • Ability to act effectively under pressure with initiative, tact, and poise.
    • Graduate of an accredited college or university; BSN preferred.
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