Revenue Cycle Management Coding Auditor

The Opioid Epidemic is a public health crisis with a highly effective but underutilized clinical intervention - millions of Americans are physically dependent on Opioids but only 10% of those likely to have OUD actually access treatment. Bicycle Health addresses this gap by maximizing accessibility, affordability, and overall quality of care by enabling highly qualified clinicians to reach patients broadly and efficiently through our online platform.

The Revenue Cycle Management Auditor audits medical record documentation to identify under coded and up coded services; prepares reports of findings and meets with providers to provide education and training on accurate coding practices and compliance issues. Interacts with providers and management to review and/or implement codes and to update charge documents. Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services.

Location:
Remote

Schedule
: 40hrs

Target Pay:
$32.00-$37.00 per hour - Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.

RESPONSIBILITIES:

• Responsible for examining medical records, clinical documentation and claims to verify the accuracy and completeness of assigned codes.
• Responsible for identifying discrepancies, errors and inconsistencies in coding and billing practice. Including the potential of fraud, waste, and abuse (FWA).
• Ensures all federal and state regulations, Medicare and Medicaid rules and other payer guidelines are being followed
• Creates reports on identified errors and trends and recommends process improvements to management
• Collaborates with compliance, billing, clinical and clinical leadership to resolve any coding discrepancies.
• Responsible for maintaining a tracking system for all audits/requests activity throughout all levels of appeals.
• Researches new healthcare related questions as necessary to aid in investigations and stays abreast of current medical coding and billing issues, trends and changes in laws/regulations.
• Recommends possible interventions for loss control and risk avoidance based on the outcome of the investigation.
• Reviewing Chart Records to confirm accurate documentation to decrease audit concerns and documenting findings.
• Assisting our Compliance Officer with coding training documentation to better equip our providers
• Establishing workflows, policies and procedures, software analysis and maintenance and implementation of processes and communication plans for the facility's interactions with third party auditors
• Pre and post