Job Posting DescriptionThe Billing Compliance Auditor II is responsible for:
Following established protocols, selecting and reviewing a percentage of records to assess coding documentation, billing, and/or reimbursement practices for compliance with all regulations of federal and state agencies and third-party payors and hospital policy.Maintaining review data and providing feedback to relevant areas in collaboration with appropriate personnel. Assigning performance scores and risk rating based on audit results.Investigating, evaluating, and identifying opportunities for improvement in conjunction with appropriate personnel, and recognizing their relative significance in the overall system. Providing guidance to departments regarding internal controls. Developing and drafting billing and coding policies for the CHB Foundations in coordination with the Hospital.Developing and maintaining professional skills and knowledge through attendance at relevant conferences, seminars, and other educational programs. Participating in professional organizations and reviewing current literature.Contributing to the teamwork within and between departments and organizations that support hospital operations.Providing positive and effective customer service that supports departmental and hospital operations.Schedule: M-F, 8a-4:30p, hybridTo qualify, you must have:
- High School Diploma/GED. Bachelor's degree preferred.
- Professional Billing Coding certification (CPC, CCS-P)
- Two years CPT and ICD10 coding experience; including some experience reviewing physician documentation and assisting physicians to meet CPT and ICD10 coding requirements.
- The level of knowledge typically acquired through completion of a Bachelor's degree in Health Information Management or Nursing and one to three years experience reviewing physician documentation and assisting physicians to meet government and other third party payer and CPT and ICD9 coding requirements.
- Knowledge of healthcare compliance regulations. Some experience providing individual and/or group physician training and/or experience in one or more medical specialties is a plus.
- 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 OR design relatively complex systems and programs that cross department/divisional lines.
- Communication skills in order to effectively deal with conflicting views or issues and mediate fair solutions, and well developed writing skills.
Boston Children's Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, childcare and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes.