Greater Baltimore Medical Center (GBMC)
Auditor - Part-time (20 hours a week)
Greater Baltimore Medical Center (GBMC), Baltimore, Maryland, United States, 21276
Under general supervision, ensures that hospital charges are accurate and appropriate to maximize hospital recoveries, maintain compliant charging practices and patient relations.Education :Bachelors Degree in nursingLicensure :RNExperience :3 yrs of related experience in medical billingSkills :
Knowledge of the International Classification of Diseases and CPT coding system.Knowledge of medical terminologySkills in written and oral communicationAdvanced skill in using database software and personal productivity applicationsAbility to interpret medical terminology and decipher physicians' handwritingAbility to understand interfaces between computerized data collection, scheduling and patient accounting systems.Principal Duties and Responsibilities:
Researches and corrects complex clinical charge errors. Identifies negative trends and elevates issues to all parties responsible for resolution.Resolves patient complaints related to charge issues. Determines services rendered from research of medical records and provides explanation of patient charges. Assists patients with proper interpretation of bill. Identifies inappropriate billing.Reviews late charge report and daily trends audit. Communicates errors and process issues to Finance and all parties responsible to avoid incorrect billing and late charges.Provides patients with price estimates for unique or complex inpatient procedures. Ensures unusual or more complex cases are coded correctly.Reviews denials from Insurance Carriers. Educates patients on the codes used and/or determines correct codes. Determines if account requires doctor's order to make changes where appropriate.Appeals technical and clinical denials based on information obtained from registration/insurance verification notes and medical records. Follows-up on appeals until resolved. Tracks and trends denials until resolved.Reviews RTP from Medicare daily to ensure appropriate coding and to review denials.Assists ROI Collection Agency with billing concerns and missed diagnoses to recover bad debt.Identifies and communicates issues with the Billing Compliance Committee. Represent Patient Accounting in Billing Compliance Committee meetings.COVID-19 VaccinationAll applicants must be fully vaccinated against Covid-19 or obtain a GBMC approved medical or religious exemption prior to starting employment at GBMC Healthcare, to include Gilchrist and GBMC Health Partners.Equal Employment OpportunityGBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
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Knowledge of the International Classification of Diseases and CPT coding system.Knowledge of medical terminologySkills in written and oral communicationAdvanced skill in using database software and personal productivity applicationsAbility to interpret medical terminology and decipher physicians' handwritingAbility to understand interfaces between computerized data collection, scheduling and patient accounting systems.Principal Duties and Responsibilities:
Researches and corrects complex clinical charge errors. Identifies negative trends and elevates issues to all parties responsible for resolution.Resolves patient complaints related to charge issues. Determines services rendered from research of medical records and provides explanation of patient charges. Assists patients with proper interpretation of bill. Identifies inappropriate billing.Reviews late charge report and daily trends audit. Communicates errors and process issues to Finance and all parties responsible to avoid incorrect billing and late charges.Provides patients with price estimates for unique or complex inpatient procedures. Ensures unusual or more complex cases are coded correctly.Reviews denials from Insurance Carriers. Educates patients on the codes used and/or determines correct codes. Determines if account requires doctor's order to make changes where appropriate.Appeals technical and clinical denials based on information obtained from registration/insurance verification notes and medical records. Follows-up on appeals until resolved. Tracks and trends denials until resolved.Reviews RTP from Medicare daily to ensure appropriate coding and to review denials.Assists ROI Collection Agency with billing concerns and missed diagnoses to recover bad debt.Identifies and communicates issues with the Billing Compliance Committee. Represent Patient Accounting in Billing Compliance Committee meetings.COVID-19 VaccinationAll applicants must be fully vaccinated against Covid-19 or obtain a GBMC approved medical or religious exemption prior to starting employment at GBMC Healthcare, to include Gilchrist and GBMC Health Partners.Equal Employment OpportunityGBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
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