Clinical Revenue Auditor - CDM, PFS, Corporate - Full-Time - Days - Hybrid
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The role
The Clinical Revenue Auditor ensures all billable clinical services are accurately documented, coded, and submitted for reimbursement.
Acts as a bridge between clinical care and billing to protect the organization’s financial health and ensure compliant reimbursement.
Performs thorough charge capture audits, identifies missing or incorrect charges, and resolves gaps between documentation and billing.
Conducts root cause analyses, develops corrective action plans, and collaborates with clinical, coding, billing, and IT teams to optimize workflows.
Maintains knowledge of CMS guidelines, HIPAA privacy, payer policies, and manages payer audit requests, denials, and appeals as needed.
Requires clinical background, strong coding knowledge (CPT/ICD-10), Epic experience, data analytics, and excellent communication and collaboration skills.
Acts as a bridge between clinical care and billing to protect the organization’s financial health and ensure compliant reimbursement.
Performs thorough charge capture audits, identifies missing or incorrect charges, and resolves gaps between documentation and billing.
Conducts root cause analyses, develops corrective action plans, and collaborates with clinical, coding, billing, and IT teams to optimize workflows.
Maintains knowledge of CMS guidelines, HIPAA privacy, payer policies, and manages payer audit requests, denials, and appeals as needed.
Requires clinical background, strong coding knowledge (CPT/ICD-10), Epic experience, data analytics, and excellent communication and collaboration skills.
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