At Boston Children's Hospital, success is measured in patients treated, parents comforted and teams taught. It's in discoveries made, processes perfected, and technology advanced through major medical breakthroughs and small acts of kindness. And in colleagues who have your back and patients who have your heart. As the teaching hospital of Harvard Medical School, our reach is global and our impact is profound. Join our acclaimed Billing Compliance Department and discover how your talents can change lives. Yours included.
This Senior Hospital Billing Compliance Auditor will be responsible for:
Performing audits for hospital billing compliance by reviewing medical record documentation for documentation compliance for billed CPT, Level II HCPCS and ICD-10 diagnosis codes.
Determining that governmental and third party payer regulations are being complied with as evidenced in medical record documentation; and evaluating appropriateness of billing and coding procedures.
Utilizing audit software to perform hospital billing compliance audits.
Preparing audit reports and performing follow up education to clinical Departments based on results of audit.
Working collaboratively with appropriate personnel to identify and recommend strategies for process improvement and to develop and draft billing and coding policies.
Working with clinical Departments on hospital billing compliance initiatives.
Assisting in response to billing audit requests from outside the institution (e.g., government audits).
To qualify, you must have:
The level of knowledge typically acquired through completion of a Bachelor's degree in Health Information Management or Nursing and three (3) to five (5) years' experience working with Hospital coding and billing, including assisting Hospital to meet government and other third party payer and CPT and ICD-10 coding requirements.
Knowledge of healthcare compliance regulations.
The ability to read and understand medical record documentation.
The analytical skills to collect information from diverse sources, apply professional principles in performing various analyses, and summarize the information and data in order to solve problems.
Communication and collaboration skills in order to effectively deal with conflicting views or issues and mediate fair solutions, and well-developed writing skills.
A Professional Billing Coding certification (CPC, CCS-P) required.
This position is eligible for an Employee Referral Bonus.
Boston Children's Hospital offers competitive compensation and unmatched benefits, including an affordable health, vision and dental insurance, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition Reimbursement, and discounted rates on T-passes (50% off). Discover your best.
Boston Children's Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.
Internal Number: 2856971
About Boston Children's Hospital
Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care. As one of the largest pediatric medical centers in the United States, Children's offers a complete range of health care services for children from birth through 21 years of age.