AUDIT COORDINATOR

At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development.

Discover why Cooper University Health Care is the employer of choice in South Jersey.

This position is responsible for the coordination of external reviews / audits, including but not limited to Medicare RAC, Medicaid RAC, or successor organizations; Medicare and/or Medicaid pre and / or post documentation requests, including but not limited to ADR, CERT, area wide and/or probe reviews.

This includes but is not limited to 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 including but not limited to pre and post payment Medicare, Medicaid and their respective Recovery Audit Contractors (RAC) reviews to ensure timely completion or review/audit documentation requests.

This position is responsible for the oversight of all pre and post payment audit functions and is responsible for maintaining a tracking system for all audit activity throughout all levels of appeals. 

The Audit Coordinator is responsible for the writing and submission of basic payer appeal, including review and submission of supporting documentation and regulations

The Audit Coordinator will analyze review/audit findings, denials to identify problems in processes, get the information to key people to evaluate, including preparing and sending reports weekly to Chief Compliance Officer; VP Revenue Cycle; Medical Director Utilization Management; Director of Case Management and others as identified/assigned 

Must have clinical or patient accounting background with fundamental knowledge of the Revenue Cycle Process, which includes patient access, case management/utilization review, charge capture, HIM, patient accounting, billing and coding compliance.

In-depth familiarity with third party billing requirements, governmental regulations and billing documentation compliance requirementspertaining to hospital and ambulatory reimbursement.

Minimum of 1 years’ experience coordinating third party audit review cycle  from receipt of documentation request through finalizing results with payers and/or governmental agencies

Experience writing and submitting basic payer appeal, including review and submission of supporting documentation and regulations

Associate’s degree or equivalent experience required; bachelor’s degree preferred

Coding certification, such as CPC, CPC-H, CCS, CCS-P, preferred