RCM Auditor, Dental

RCM Auditor, Dental:

Shifts:

• Night Shift: 6:30 pm IST to 3:30 am IST
• Day Shift: 8:00 am IST to 5:00 pm IST

Overview: As a Dental Revenue Cycle Management (RCM) Auditor, you play a pivotal role in ensuring the financial health and compliance of billing processes within dental practices or organizations. Your meticulous review of patient accounts, coding, billing practices, and documentation is essential for identifying discrepancies, errors, and areas for improvement.

Responsibilities:

1. Audit Planning and Execution:
   • Develop comprehensive audit plans aligned with organizational goals and industry regulations
   • Conduct audits of revenue cycle processes, including patient contracting, insurance and patient accounts receivables, cash management, and coding
   • Oversee testing of transactions and adjustments to ensure compliance with company, payer, and government policies
   • Assess internal controls' effectiveness and identify opportunities for enhancement
   • Compile audit results into detailed reports identifying deficiencies and recommending workflow improvements
2. Collaboration and Training:
   • Collaborate with cross-functional teams, including billing, accounts receivable, operations, finance, and clinical departments
   • Provide training on revenue cycle best practices, compliance, and audit findings to enhance staff expertise
3. Process Documentation:
   • Develop and maintain procedural documentation to streamline audit processes
   • Create flow charts and job aids to support procedural audits and staff training
   • Contribute to the development of policies and procedures for the RCM department
4. Data Analysis and Reporting:
   • Utilize data analytics tools to analyze financial and operational data related to the revenue cycle
   • Generate comprehensive reports highlighting audit findings, trends, and improvement opportunities
   • Present findings to key stakeholders and collaborate on action plans to address identified issues
5. Regulatory Compliance:
   • Stay updated on healthcare regulations, payer guidelines, and industry trends impacting revenue cycle management
   • Ensure compliance with coding and billing regulations, such as HIPAA and Medicaid, and provide guidance on regulatory changes

Qualifications:

• 1-2 years of experience in healthcare revenue cycle management, auditing, or related field
• In-depth knowledge of healthcare revenue cycle processes, coding principles, and regulatory requirements
• Previous experience with coding and compliance audits strongly preferred
• Advanced knowledge of Excel, including Vlookup, Index, Match, and pivot tables
• Intermediate proficiency in business intelligence software such as PowerBI or similar tools
• Familiarity with internal audit program methodologies and core revenue cycle KPIs
• Strong customer service skills
• Experience with auditing tools and data analytics preferred

Why Join Us:

• Opportunity to play a key role in shaping our organization's success by driving HR initiatives and supporting our team members
• Collaborative and supportive work environment with opportunities for professional growth and development
• Join a team dedicated to fostering a positive work culture and creating opportunities for career advancement

Our Values System:

At CEC, we believe in motivating each other and embodying the 4E's: Energy, Engagement, Enthusiasm, and Ethical behavior. Heres how we put these values into action:

1. Energy: We bring a positive and proactive attitude to everything we do. We approach challenges with vigor and determination, inspiring others to do the same.
2. Engagement: We fully immerse ourselves in our work, projects, and relationships. Our commitment to engagement fosters a culture of trust, respect, and accountability, enabling us to achieve collective success.
3. Enthusiasm: We approach each task and interaction with genuine passion and excitement. We celebrate achievements, big and small, and take pride in our work, knowing that our enthusiasm drives exceptional results.
4. Ethical behavior: We uphold the highest standards of integrity, honesty, and ethical conduct in all our dealings. We prioritize transparency, fairness, and respect for all individuals, regardless of background or position.