Revenue cycle management is the branch that manages claims processing, payment and revenue generation. A HIM revenue cycle auditor is responsible for identifying areas of non-compliance in both the areas of coding and revenue cycle data collection practices. The auditor responds to any reported issues resulting from the revenue cycle audit and provides recommendations for coding, data collection, and documentation.
A medical coding certification is required for this position such as CCS-P, CPC, CCS, in addition to 4+ yrs. of experience in coding, billing and reimbursement, experience coding in a clinical setting, ICD-9, and an extensive knowledge of medical coding terminology.
- Review coding and medical documentation associated with patient
- Check revenue cycle data for accuracy and regulatory compliance
- Analysis of any data changes affected by system interfaces and back-end revenue cycle activities
- Report findings in an Excel spreadsheet or Access Database
- Provide feedback and assist during the corrective action process
- Maintain current knowledge of coding conventions, changes and regulation
- Extensive knowledge of medical terminology
- Medical Coding (CPT-4 and ICD-9-CM)
- Strong written and verbal communication skills
- Basic knowledge of the revenue cycle
- Knowledge of Microsoft Office (Word, Excel, Access, and PowerPoint)