#1 PH Workforce Delivering to the US.
BizForce and our healthcare division, MedCore Solutions, are seeking a skilled and detail-oriented Charge Entry Auditor (Permanent Work from Home) to join our team. As a Charge Entry Auditor, you will be responsible for reviewing and auditing medical claims to ensure accuracy and compliance with coding guidelines and billing regulations. This role plays a critical part in ensuring the financial health of our clients by maximizing revenue and minimizing reimbursement denials. If you have a strong understanding of US healthcare regulations, excellent attention to detail, and a passion for delivering quality healthcare services, we encourage you to apply today!
Who We Are
MedCore Solutions (MCS) is a single source solution for Healthcare administration. MCS is an industry leader for medical billing, credentialing, scribing, insurance verification, compliance and virtual staffing.
We offer an expansive suite of administrative products and trainings to keep your practice and its employees safe and up to date with compliance and to avoid fines and litigation. Our online compliance center is quick and easy to use, and provides you with an extensive library of training courses, covering OSHA, HIPAA, Human Resources, Health Plan Management, Patient Safety and Regulations, Infection Control, and much more.
Responsibilities
- Review and audit medical claims for accuracy and compliance with coding guidelines and billing regulations
- Identify and rectify coding errors and discrepancies
- Ensure proper charge entry for services rendered
- Collaborate with internal teams to resolve claim-related issues
- Provide education and training to coding and billing teams regarding documentation and coding guidelines
- Maintain knowledge of current coding and billing regulations and industry updates
- Liaison between Revenue Cycle and the managed care payors in the escalation of revenue cycle issues that prevent NM from realizing correct reimbursement in accordance with the managed care contracts.
- Collaborates with many internal departments to gather payor issues to escalate and work with payor to resolve. Internal departments include but are not limited to: Patient Accounting, Access, UM, QU, Compliance, Legal, Risk management, clinical areas, IT, Medical Records, CVO, Quality.
- Works with external Revenue Cycle Vendors and consultants when directed to for project work or resolution of payor issues.
- Responsible for validating contract rates and rate language loaded into EPIC in conjunction with MC Specialist prior to contracts being uploaded into the live environment.
- Responsible for understanding the terms of the managed care contracts assigned to be able to assist other areas when needed.
- Investigates issues to understand root cause and makes recommendations for resolutions.
- Responsible for holding regularly scheduled meetings with Revenue Cycle to review outstanding payor issues.
- Responsible for coordinating monthly payor meetings with Revenue Cycle teams and payor representatives to bring issues to resolution.
- Performs special projects related to AR or payor contracts as assigned by supervisor.
Other Details:
Possible start date will be in 2 weeks or earlier
8 hour shift Monday-Friday (graveyard shift; US work hours)
Weekend days off
- Minimum 3 years of experience in charge entry or medical billing/coding/auditing in the US healthcare industry
- Proficient understanding of CPT, HCPCS, and ICD-10 coding guidelines and procedures
- Knowledge of medical billing, accounts receivables, claim submission, and reimbursement processes
- Strong attention to detail and analytical skills
- Excellent written and verbal communication skills
- Ability to work independently and collaboratively in a team environment
- Proficient in using electronic medical record (EMR) systems and billing software
- Excellent interpersonal skills
- Excellent written and oral communication skills
- Amenable to work in a graveyard shift
Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.
- Permanent Work From home
- Permanent Weekends Off
- Great Company Culture and No Micromanagement
- Continued Education
- Specialized Training
