Revenue Auditor Job Description
Revenue Auditor Duties & Responsibilities
To write an effective revenue auditor job description, begin by listing detailed duties, responsibilities and expectations. We have included revenue auditor job description templates that you can modify and use.
Sample responsibilities for this position include:
Revenue Auditor Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Revenue Auditor
List any licenses or certifications required by the position: CIA, CPA, CISA, CISSP, CPMA, CCT, CRCS, CPC, CCS, CCA
Education for Revenue Auditor
Typically a job would require a certain level of education.
Employers hiring for the revenue auditor job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Accounting, Business/Administration, Finance, Auditing, Economics, Education, Associates, Technical, Administration, Management and Business
Skills for Revenue Auditor
Desired skills for revenue auditor include:
Desired experience for revenue auditor includes:
Revenue Auditor Examples
Revenue Auditor Job Description
- Assist FH/Managed Care Department when outside agencies conduct audits involving hospital billing
- Work closely with FH/Managed Care department when outside agencies request chart audits
- When customer service complaints related to charges are received conducts research into the legitimacy of the charge
- Logs price and billing complaints and reports results to supervisor
- Works closely with PFS/HIM/Finance to research and correct specific problem accounts or areas
- Certain charge issues that appear on the interface rejection report, SSI edits or coding software will be referred to the nurse auditor for research and possible correction
- When charge errors require correction by the department who generated the original charge
- May conduct ongoing departmental charge audits that are focused on checking for specific charge problem areas procedure billing of observation accounts
- Monitors charge accuracy levels for all revenue producing departments
- Conducts charge audits checking physician orders, clinical documentation and reports against billed charges
- Minimum of 3 years’ experience in Revenue Cycle, preferably with a large, complex health system
- Prior revenue auditing experience is preferred
- Provides revenue producing departments with a report of their charge accuracy levels
- Makes process improvement recommendations to departments that have been audited
- When requested, leads out in charge accuracy improvement meetings that address specific process and charge issues
- Charge questions that are raised by departments will be researched with the involvement of the corporate CDM/HIM/PFS departments to ensure that the issue is addressed by the proper individuals at the corporate office
Revenue Auditor Job Description
- Reviews and compiles all paperwork produced by Player Services and all revenue producing outlets
- Monitors compliance of policies and procedures
- Assemble work papers, perform pre-audit analysis, gather property data and prepare audit request letter (for desk audits only) to licensee representative
- Perform system audits to identify properties whom are miscoding Gross Room Revenue transactions, inappropriately adjusting Gross Room Revenue, or incorrectly reporting Gross Room Revenue totals
- Perform desk and field audits in accordance with standard procedures
- Negotiate settlements, set-up billing and assist with collections of audit fees
- Lead Revenue Cycle Audit Team Coding Reviews focusing on modifier, CPT and diagnosis coding issues captured on the Clinical Billng Log
- Maintain the Identity Theft Log
- Accurately process closing reports through Infogenesis
- Review system documents for accuracy
- A positive attitude and ability to work productively with peers and other stakeholders – Preferred
- Ability to communicate effectively with all levels of employees, outside contacts
- Must be able to bend, stoop, crouch, squat, crawl, climb, stand, sit and turn/pivot
- Must be able to supervise and train employees effectively
- Must be comfortable with decision making and have excellent time management skills
- Self-motivated and works well with limited direct supervision
Revenue Auditor Job Description
- Plans and conducts audits in accordance with the approved Compliance and Audit Work Plan
- Assists with the development and revision of HHC and Department Policies and Procedures
- Responsible for auditing of daily sales reports, verifying complete and accurate reporting of revenue, receipts, discounts, comps
- Ensuring that all appropriate billing charges are being captured, documented, charged and reimbursed for the assigned department in accordance with policies and procedures, and applicable regulatory standards and requirements
- Identifies proactive opportunities to strengthen charge capture processes, enhance regulatory compliance and facilitate appropriate revenue capture
- Responds to third-party audits charge recovery vendor solution audits
- Provide training and education to clinical/charging staff & management on appropriate documentation and charge capture processes
- A positive attitude and ability to work productively with others both within the department and in other areas (IT, G/L)
- Primarily responsible for assessing business processes and performing control tests over compliance, reporting and operational controls
- Focus will be on verifying that control processes are designed appropriately and operating effectively and efficiently, processes are performed accurately and that any evidence supporting the control is complete and adequately documented
- Conduct audits of procedures and methods for the different UPS Systems
- Generate reports to be used by the finance department
- Must follow UPS appearance guidelines
- Minimum 1 - 2 years of progressive experience in financial analysis or auditing in public accounting or corporate accounting environment
- Ability to travel to remote locations up to 10% of the time and possess a valid Driver’s License
- Certified Internal Auditor (CIA) designation or willingness to work toward certification
Revenue Auditor Job Description
- Identify root-cause of audit issues identified and process anomalies as determined through testing procedures
- Be able to prioritize assignments, apply sample size guidelines appropriately and provide constant and clear feedback to management and the process owners
- 5%) Participate in integrated audits, process redesign efforts, and other projects as requested
- Prepare and completes daily audits
- Generate daily reports and reconcile large audit variances
- Generate clear and legible scanned images for the audit and accounting processes
- Review whether the complexity of the E/M level meets the medical necessity criteria for the code level assigned
- Under direct supervision, reviews the coding of diagnoses and E/M level verifying the proper codes were assigned
- Review daily sales reports for complete backup, adherence to closing procedures and matching reported cash to the source system
- Provide training as needed to BU’s not following proper procedures
- Working knowledge of Medicare/Medicaid and Managed Care reimbursement
- Working knowledge of Hospital IP/OP coding and/or Physician coding
- Hunger for proper revenue/reimbursement capture
- Exceptional communication and facilitation skills required
- Financial acumen related to job functions
- Exceptional persuasion/negotiation skills
Revenue Auditor Job Description
- Complete assigned daily, weekly and month-end duties
- Provide assistance and research to resolve BU and/or Accounting issues
- Communicate with all levels of Intrawest employees and management
- Daily verification of the consolidated cash deposit
- Reconciliation of credit card chargebacks
- Evaluate revenue cycle processes and controls to mitigate compliance risks and strengthen operational processes
- Plan, organize and conduct revenue cycle and regulatory reviews as outlined in the audit plan
- Prepare clear, concise and objective audit reports of findings, observations, and corrective action for management
- Ensure the adequacy and follows up on completion of corrective action plans
- Perform risk assessments to identify and analyze risk areas for the purposes of drafting, communicating and executing action plans
- Highly detailed and analytical
- 4) year college graduate or (2) year degree or equivalent, coding or audit certification preferred or candidate must have in place of a college degree 7+ years of hospital or clinic revenue cycle experience with a certification such as CPC or CPMA
- 5-7 years in hospital setting, clinic setting, or insurance company managing revenue/reimbursement functions will ensure a successful candidate
- Ability to research CMS and federal register sites without difficulty
- PC knowledge for daily use (MS Office)
- 1+ years of experience in non-gaming and/or hotel audit