Revenue Auditor

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.