DRG Clinical (RN) Validation Auditor auditing inpatient medical records to ensure accuracy in billing and reimbursement. Specializing in Diagnosis Related Group (DRG) paid claims with a focus on clinical documentation integrity.
About the role
- Revenue Auditor assessing medical record audits and charge reconciliation at Cedars-Sinai. Join a recognized organization in patient financial services to ensure maximum revenue integrity.
Responsibilities
- Performs audits of medical records against submitted professional charges/the itemized bill
- Performs special audit requests for the department
- Performs daily reconciliation of the submitted professional charges by all providers
- Daily review and clear 40 – 50 accounts
- Daily follow-up with providers, clinical staff, the Coding department, Billing Compliance, and Revenue Integrity
- Review and create a daily statistical log of all patients, procedures, and participants
- Monitor and track all unbilled services by providers
- Performs quality assurance reviews of account documentation
- Coordinates and reports audit outcome regarding charge errors
- Investigates any appearance of production anomalies
- Performs recurring data compilations
- Serves as co-administrator of patient accounting system applications
- Responsible for auditing clinic charge capture in department
- Prepares the monthly Accounts Receivable (AR) valuation report
- Participates in month-end impact projects
Requirements
- High school diploma/GED required
- Associate's degree or college diploma with courses in business, accounting, computer operation and applications preferred
- A minimum of one year of charge auditing experience required, with three years preferred
- Coding experience a plus.
Benefits
- paid time off
- healthcare
- 403(b)
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