Portland, OR, United States
Job Description
This is a remote position. The salary range is $26.28 – $39.39/hour.
Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus – a rejuvenating place for associates systemwide to collaborate, innovate and connect.
Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.
Job Summary:
Examines medical records, billing information, medical processes and regulation to identify inaccuracies, compliance issues and inefficiencies. Verifies medical record information with medical professionals and verifies the accuracy of these records. Completes audits; ensuring compliance with regulations and makes recommendations for improvements. Works on problems of moderate to diverse scope requiring some interpretation of policies and guidelines. Applies working knowledge of the techniques, principles, theories and concepts to complete routine and non-routine assignments.
Job Requirements:
Education and Work Experience:
- Associate’s/Technical Degree or equivalent combination of education/related experience: Required
- Bachelor’s Degree: Preferred
- Three years’ Healthcare clinical and/or Revenue Cycle experience: Preferred
- Medical Insurance Utilization Management/Case Management experience: Preferred
- Knowledge of Interqual/Milliman guidelines: Preferred
Licenses/Certifications:
- Certified Professional Medical Auditor: Preferred
Essential Functions:
- Prepares for audit by researching materials; formulating a plan of action. Ensures compliance with regulations and controls by examining and analyzing records, reports, operating practices, and documentation.
- Monitors expenses, implementing cost-saving actions and verifies assets and liabilities by comparing items to documentation. Completes audit and memorandums by documenting audit tests and findings.
- Supports external auditors by coordinating information requirements. Provides management reports by collecting, analyzing, and summarizing management information.
- Performs other job-related duties as assigned.
Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.
About Us
Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God’s love by inspiring health, wholeness and hope.