Lead Health Information Management Audit Specialist
Core
Lead Health Information Management Audit Specialist responsible for third-party audits of medical records for reimbursement, regulatory compliance, quality, and appropriateness at Beth Israel Lahey Health.
Role type
Senior IC Health Information Management Audit Specialist
Builds
Audit reports, compliance documentation, and appeals for CMS, CERT, RACs, and DRG Insurers
Domain
Healthcare administration and regulatory compliance
Required skills
Medical terminology, anatomy and physiology, general coding guidelines, EHR systems, Microsoft Word, Microsoft Excel, project management, analytical problem-solving
Preferred skills
Clinical background (RN or LPN), HIM degree, Coding certification
Technologies
Epic, Cobius Health, ECMS, Documentum, PowerPoint
Responsibilities
Plan and evaluate audit procedures, prepare and report audit status and outcomes, oversee adherence to audit standards, lead and assist with audits for CMS and other payors, research and analyze CMS requirements, act as system administrator for audit tracking, train auditors on systems, formulate appeals with physicians and billing personnel, respond to third-party payor requests, coordinate audits and projects.
Seniority
Senior, hands-on IC