BJC HealthCare has an opportunity for an Audit Compliance Specialist.
This role is responsible for managing pay audit requests from managed care organizations, Medicare, Medicaid, and VA to ensure accurate payments and identify potential overpayment's.
Ideal candidates will have some coding knowledge or revenue cycle/billing background to analyze payment details and procedure types, distinguishing between valid and invalid charges.
Remote position, must reside in the Greater St. Louis area.
BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.
BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.
BJC’s patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children’s Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country.
Role Purpose
Perform insurance billing and process audits and assists with special projects. Serve as a regulatory consultant and resource to management and departments at all levels and assist in developing appropriate action plans. Requires a high degree of analytical skills, the ability to work independently, the ability to maintain confidentiality and to be a catalyst for change.
Responsibilities
Minimum Requirements
Education
Experience
Supervisor Experience
Preferred Requirements
Licenses & Certifications
BJC Total Rewards
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The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer
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