Payer Auditor

Providence Health & Services Anchorage , AK 99501

Posted 1 week ago

Providence is calling a Payer Auditor (Revenue Cycle Integrity, Day, 1.0 FTE) to Providence Alaska Medical Center in Anchorage, Alaska. We are a community of caregivers delivering every day on our Mission to provide compassionate care that is accessible for all - especially those who are poor and vulnerable.

In this position you will:

  • Use knowledge of regulatory, statutory and policy requirements of payers, claim coding logic, accepted standards of care and clinical research to support the validity of the claims.

  • Collaborate with the Senior Payer Auditor to report trends and recommend operational improvements.

  • Act as a subject matter expert to clinicians and administrative staff regarding regulatory, statutory and policy related reimbursement requirements of multiple payers.

  • Organize and prioritize assigned work and schedule time to accommodate work demand, turnaround time requirements and commitments.

  • Understand and comply with policies and procedures related to medical legal matters, including confidentiality, amendment of medical records, release of information, patient rights, medical records as legal evidence, informed consents, etc.

Required qualifications for this position include:

  • 1 year work experience or equivalent with:

  • Healthcare auditing experience involving the interpretation and application of various regulatory, statutory, clinical policy bulletins and other payer requirements related to reimbursement and standards of care

  • Reconciliation of healthcare claims to assure accuracy and appropriateness of charges

  • Appeal or technical writing experience with demonstrable ability to incorporate relevant research and regulatory requirements

  • Electronic medical records

  • Quality Improvement methodologies, including Analysis, Measuring, Tracking, Trending, Reporting and Sustaining Outcomes; and,

  • Direct patient care or experience as an allied health position within the acute care setting

  • Advanced knowledge pertaining to:

  • Regulatory, policy and statutory requirements relating to healthcare reimbursement;

  • Payer appeal processes, timeliness and filing requirements;

  • Appropriate resource utilization based on accepted standards of care;

  • Standards for healthcare auditing and professional codes of conduct; and,

  • UB Claim format and coding logic (CPT, HCPCS, ICD9/10, Condition, Occurrence, and Value codes)

  • Advanced persuasive and technical writing skills

  • Advanced proficiency with multiple software applications including: Word, Excel, Publisher, VISIO, Tableau and Access or other database systems.

  • Ability to apply statistical analysis related to research findings and internal performance assessments

Preferred qualifications for this position include:

  • Bachelor's Degree with healthcare related major

About Providence Alaska Medical Center

Providence Health & Services Alaska is among nation's best employers for healthy lifestyles! The National Business Group on Health, a non-profit association of large U.S. employers, has honored Providence Alaska for its commitment and dedication to promoting a healthy workplace and encouraging our caregivers (employees) and families to support and maintain healthy lifestyles. Mountain-Pacific Quality Health has awarded Providence Alaska Medical Center with its Quality Achievement Award for high-quality care in the areas of heart attack, heart failure, pneumonia and surgical infection prevention. This is the highest honor awarded by Mountain-Pacific.

As the state's largest hospital, Providence Alaska Medical Center provides full-service, comprehensive care to all Alaskans, a role unmatched by any other in the state. Within our community, you will find top notch ski resorts, kayaking, and wildlife. Enjoying the outdoors is just one of many reasons to live in and explore Alaska!


icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Hotel Night Auditor (Rotational) Nullagvik

NMS USA

Posted 2 months ago

VIEW JOBS 8/12/2019 12:00:00 AM 2019-11-10T00:00 About NMS Built on a culture of safety and integrity, NMS delivers award-winning, integrated support services to a variety of clients in food service, facilities management, camp services, security and hotel management in Alaska and the continental U.S. We are proud to serve not only our original oilfield clients, but also clients from federal, state and local governments, corporate facilities, healthcare institutions, schools and universities, manufacturing centers, and the transportation and telecommunications industry. Our clients have peace of mind knowing we are committed to delivering best-in-class service, and we bring creativity, technology and experience to every project. Our mission is to provide management and support services at a level of quality, value, safety and expertise beyond our clients' expectations. At NMS, we expect our employees to fulfill that mission in every aspect of their work. Summary The Hotel Night Auditor position is responsible for the hotel and all front desk related functions during various night hours. Essential Duties and Responsibilities * Provide the highest quality of service to the customer at all times and maintain the hotel's high standard of service and hospitality. * Greet and register guests and provide room assignments accommodating special requests whenever possible. Assist guests with luggage and/or other personal items. * Handle checkouts efficiently and in a friendly and professional manner. * Communicate with previous shift, organize shift and review remaining reservations that are to arrive. * Verify that all updated contingency reports have been run. * Ensure credit card draft capture is in balance. * Print registration cards for next day arrivals. * Verify GTD no shows and complete walked guest report. * Complete and deliver express checkout envelopes before 5:00 A.M. * Ensure that all wake up calls are handled promptly and properly. * Complete a "person in charge" security report identifying any unusual events. * Post room charges and collect payment following all cash handling procedures as required. * Balance accounts to zero, including all rebates, paid outs and other misc. charges. * Inform management of any discrepancies. * Complete, print and leave all required reports at the assigned areas for designated managers. * Conduct ongoing verification of hotel security with the Night Housekeeping/Security Aide. * Monitor Night Housekeeping/Security Aide to ensure the assigned duties are completed. * Assist with guest complaints and situations that require immediate attention. * Keep front desk clean and stocked with necessary inventory. * Have a thorough knowledge of emergency procedures. * Train the Night Housekeeping/Security Aide to cover Front Desk to ensure it is always attended. * Support the hospitality programs. * Wear proper uniform at all times as specified in associate handbook. * Adhere to all work rules, procedures and policies established by the company, including, but not limited to, those contained in the associate handbook. * Other duties that are pertinent to the department or unit's success also may be assigned. Minimum Requirements * High school diploma or GED equivalent. * Familiar with computer systems and cash handling. * Must be fluent in speaking, reading, and writing English. Preferred Qualifications * A valid Driver's License and an acceptable driving record for the past three (3) years to be eligible under NMS' vehicle insurance policy (may be required at other locations). Working Conditions and Physical Requirements Weather: Indoors Noise level: Moderate Office conditions: Pace of work environment: Medium Customer Interaction: High Description of environment: Hotel Constantly required to stand, occasionally required to sit. Physical requirements: Occasionally required to lift and/or move up to 50 pounds. Travel: Rotational travel to and from Kotzebue, AK for work. Competencies NMS Core Values Safety guides our behavior. Honesty and integrity govern our activities. Commitments made will be fulfilled. All individuals are treated with dignity and respect. The environment will be protected and sustained. Required Language Equal Opportunity Employer/Shareholder Preference NMS is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran protected status or any other characteristic protected by applicable law. NANA grants employment preference to shareholders of NANA and their spouses and descendants to the extent allowed by law. It is NMS policy to conduct background checks, drug testing and a physical assessment, as applicable, once an offer has been accepted, in accordance with company and/or contract requirements. Accommodation Request If you are a job seeker with a disability and require accessibility assistance or an accommodation to apply for one of our jobs, please submit a request by telephone or via email. In order to appropriately assist you with an accommodation, we ask that you please specify the assistance needed in order to access our jobsite and post for a position. The dedicated email and telephonic options are listed below and are reserved only for individuals with disabilities needing accessibility assistance. To request an accommodation by telephone, contact us at: 1-800-478-2000 To request an accommodation by email, contact us at recruiting@nana.com NMS USA Anchorage AK

Payer Auditor

Providence Health & Services