Revenue Auditor
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Madre Integrated Engineering Full time
- Perform routine audits on inpatient and outpatient medical charts to verify that clinical documentation accurately matches billed services.
- Review and maintain the Charge Description Master (CDM) to ensure accurate pricing, active codes, and structural integrity.
- Identify revenue leakage , underpayments, and missed charges, and implement corrective workflows to capture lost revenue.
- Analyze insurance claim denials to identify root causes and collaborate with billing and coding teams to prevent future rejections.
- Ensure strict compliance with CMS guidelines, OIG regulations, HIPAA, and both national (NCD) and local (LCD) coverage determinations.
- Educate and train clinical staff, physicians, and coders on proper documentation requirements and billing regulations.
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