Revenue Integrity Auditor

Chicago, IL or Remote

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Waystar Health
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Posted 3 weeks ago

Waystar modernizes the healthcare revenue cycle through innovative, cloud-based technology. We provide the highest-rated client experience to more than 450,000 providers, 22,000 healthcare organizations and 750 health systems and hospitals around the country. Together, our technology, data and client support streamline workflows and improve financials for our clients, so that they can focus on their patients. We are deeply committed to living out our organizational values: honesty; passion; curiosity; fanatical focus; best work, always; making it happen; and joyful, optimistic and fun.
What is the purpose of this position?
We are looking for a Revenue Integrity Auditor who has a comprehensive understanding of medical terminology, hospital inpatient and/or outpatient coding, charge capture, CDM, and medical records. The candidate must be organized, detail-oriented, accurate, and professional and would, ideally, possess CPC certification and other coding credentials/clinical expertise.  The ideal candidate for this position can approach problem-solving challenges independently, has strong attention to detail and enjoys working in a fast-paced, collaborative and team-based environment.  

Looking for some details?

  • Knowledge of anatomy, physiology and medical terminology
  • Remain current on CPT, ICD, HCPC and modifier coding requirements
  • Validation of potential missing charges, coding variances and overcharges using proprietary technology and medical records
  • Quality control skills
  • Analyze revenue leakage
  • Claims/Charge auditing with ability to professionally communicate findings to client
  • Analysis and process improvement of hospital charges
  • Achieve and maintain assigned Client financial performance goals
  • Assist in prediction enhancements to increase verification rates

Do you fit our team?

  • Self-sufficient with strong analytical and research skills
  • Working knowledge of hospital charging practices, payer reimbursement methodology, medical necessity criteria, and applicable industry-based standards
  • Experience preferred with one or more of the following specialties: Interventional Radiology, Invasive Cardiology, General Surgery, Orthopedic Surgery, Vascular Surgery, and Surgical Oncology
  • Ability to communicate effectively
  • Demonstrate independent judgment, discretion, and decision-making abilities
  • Self-motivated, hardworking individual with a high attention to detail
  • Excellent organization skills
  • Proficient using Microsoft Office products and the ability to work effectively with computerized programs and databases
  •  Experience
  • 5+ years of hospital auditing/coding experience with CPT, ICD, HCPCS and modifier coding
  • Experience working within the hospital environment preferred
  •  Education/Certification
  • Bachelor’s degree preferred
  • CPC, RHIT, RHIA, or other coding/clinical certifications, credentials, or expertise preferred

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.
Job tags: Cloud-based Compliance Research