Revenue Cycle Auditor
Skills
- Strong expertise in healthcare revenue cycle management, prior authorizations, claims auditing, and payer behavior.
- Experience with lab billing workflows and related systems like Xifin, Epic, Meditech, Salesforce, LIMs, and Waystar.
- Proficiency in data analysis tools such as Power BI, SQL, and Snowflake.
- Technical auditing skills especially related to automation and Jira ticket investigation.
- Excellent oral and written communication skills.
Responsibilities
- Conduct detailed audits of workflows, claims, Jira tickets, and system configurations to identify process gaps and breakdowns.
- Analyze revenue cycle pathways focusing on authorizations and claim life cycles.
- Identify root causes of denials, coding errors, and check adherence to standard operating procedures.
- Collaborate cross-functionally with billing, leadership, operations, and technical teams to improve approvals and payment processes.
- Test and validate system design and automation effectiveness before and after implementation.
- Perform technical audits on system-generated changes ensuring alignment with intended outcomes.
- Analyze large datasets using Power BI, SQL, and Snowflake to verify coding accuracy and compliance with payer requirements.
- Deliver data-driven insights via dashboards and audit reports to stakeholders.
Education
- Bachelor's degree in Business, Health Informatics, Data Science, or related field preferred.
- Equivalent professional experience considered.
Benefits
- Comprehensive medical, dental, vision, life, and disability insurance plans.
- Free genetic testing for employees and immediate family.
- Fertility care benefits and pregnancy/baby bonding leave.
- 401(k) retirement plan and commuter benefits.
- Employee referral program.
Average salary estimate
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