Hospital Bill Audit Coordinator in Largo, FL at Parallon

Date Posted: 8/21/2018

Job Snapshot

Job Description

Job Summary – Assist in managing and analyzing hospital bill audits by third party payers. Position will serve as
liaison between payors, hospitals, and the Shared Service Center (SSC) regarding status of pending, ongoing and
finalized audits. Position will evaluate the requests received by the payors to assess if the request is within the
terms established by contracts and in accordance with the Hospital Bill Audit by Third Party Payers Policy. Position
will notify appropriate responsible parties of reviews and maintain documentation of audit requests, current
status, and outcomes of audits in a centralized location. Position will track and trend types of audits received and
report findings to Manager.
Supervisor – Revenue Integrity Manager
Supervises – N/A
Key Interactions – Interacts and coordinates handoffs of audits between responsible SSC departments such as
Revenue Integrity for insurance charge audit reviews, HSC for coding or DRG related reviews and Ethics and
Compliance and HCA – Regulatory Compliance Support (Regs) for government audits. Position will communicate
with payor representatives related to audit request and coordination of audits to be performed.
Duties (included but not limited to):
 Analyze and approve audit requests received from payors
 Interact with payor to resolve questions or concerns related to coordination of audit request
 Maintain tracking of audits and coordinate obtaining the medical record for auditor to perform on-site audits
 Communicate approved and denied insurance defense audits
 Maintain statistical data as required
 Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"
 Other duties as assigned

Job Requirements

Knowledge, Skills & Abilities
 Excellent communication skills both verbal and written
 Good interpersonal skills
 Able to establish good customer relationships with trust and respect
 Excellent organizational skills
 Ability to work with limited supervision
 Excellent statistical skills
 Computer skills: navigation and edit resolution through various Web based systems, ability to use email, Excel,
Word.
 Knowledge of payer contract requirements preferred but not required
EDUCATION
 Associate degree preferred; Equivalent work experience may substitute.
EXPERIENCE
 Three years of hospital business office or related financial experience preferred.
 Project management and payor contract experience preferred.
CERTIFICATE/LICENSE
 N/A
PHYSICAL DEMANDS/WORKING CONDITIONS – Requires prolonged sitting, some bending, stooping and
stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier,
telephone, calculator and other office equipment. Requires normal range of hearing and eyesight to record,
prepare and communicate appropriate reports. Requires lifting papers or boxes up to (XX) pounds occasionally.
Work is an office environment. Work may be stressful at times. Contact may involve dealing with angry or upset
people. Staff must remain flexible and available to provide staffing assistance for any/all disaster or emergency situations.
 
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