Auditing/Compliance Assistant Job in Cuyahoga Falls 44221, Ohio Us

Now is the time to join one of the fastest growing billing service companies in Northeastern OH.  You’ll enjoy the stability and benefits of working with an 18 year old established company and the excitement and opportunities of joining a growing and winning team.  If you are a dedicated, hard worker who is looking for a real long-term job opportunity with career advancement potential – We want to talk with you.

 

ACU-Serve provides Durable Medical Equipment billing services to client providers nationwide.   We highly value and reward our employees as well as our customers. 

 

  

Compliance/Auditing Assistant

 

Summary:  This position will focus on the audit and appeals process between our clients and Medicare. 

 

Duties and Responsibilities include the following: 

 

  1. Ensure compliance with Medicare Guidelines for prepay, Complex Medical Review CERT, RAC, ZPIC, and OIG audits.

 

  1. Research, collect, and organize documentation that is needed to prove medical necessity and adhere to outlined documentation requirements.

 

  1. Knowledgeable in interpreting chart notes.

 

  1. Thorough understanding of the Medicare appeals process. 

 

  1. Participate in special projects as needed to help out departments that are behind.

 

  1. Provides additional one-on-one training with current staff as needed.

 

  1. Resolves current staff billing questions or issues.

 

  1. Communicate well with all levels of management, staff, clients, and insurance companies both written and orally.

 

  1. Other duties as assigned. 

 

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Must be able to adjust to change in a fast paced environment.  Must be able to prioritize multiple projects and work well independently.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Education/Experience:

High school diploma or general education degree (GED); or two to four years related experience and/or training; or equivalent combination of education and experience. Preferable to have three years experience filing Medicare appeals and responding to Medicare audits for a DME supplier, with exceptional understanding of the policies for CPAP and Oxygen.  A clinical background is desired. 

  

Language Ability:

Ability to read, analyze, and interpret the most complex documents. Ability to respond effectively to the most sensitive inquiries or complaints. Ability to write speeches and articles using original or innovative techniques or style. Ability to make effective and persuasive speeches and presentations on controversial or complex topics to top management, public groups, and/or boards of directors.

  

Math Ability:

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.

 

Reasoning Ability:

Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

 

Computer Skills:

To perform this job successfully, an individual should have and intermediate knowledge of Microsoft Word, strong knowledge of Microsoft Excel (formulas, charts, and pivot tables) Extensive knowledge in Brightree, Webscan, Medforce with a willingness to learn other softwares including QS/1, CU, FASTRACK, CPR+, Diabco, and Pacware.

 

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Specific vision abilities required by this job include close vision.  While performing the duties of this job, the employee is regularly required to sit, use hands, and talk or hear.  The employee is occasionally required to stand and walk.

ACU-Serve offers:

ACU-Serve is an Equal Opportunity Employer