About this role
The Code-Based Reimbursement Auditor performs audits of Charge Master driven and HIM assigned codes and medical record documentation against the itemized charges and facility assigned on government and non-government accounts and adjusts them for incorrect items and/or services; Assists with billing edit resolution and provides coverage guildelines for billable services. Relies on education, some experience and judgment to accomplish job and works under general supervision. Creativity and some latitude is expected to complete responsibilities of the role.
- 3 years experience
- Associate Degree in Nursing or HIM
- Proficient in payment review systems, payment methodologies and insurance terms. Ability to synthesize and evaluate data. In-depth knowledge of ICD-9-CM, HCPCS, CPT-4 nomenclature, codes and guidelines and 3M coding software.
- Current RHIT or LPN License