You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a Clinical Auditor to lead efforts in improving billing processes through thorough charge capture and clinical audits. The primary goal is to maximize revenue reimbursement, ensure compliance with coding guidelines, and collaborate across departments to streamline operations.

Key Responsibilities

• Conduct clinical audits to assess the effectiveness of the billing process.
• Identify and rectify missing or incorrect charges, coding errors, and inconsistencies between documentation and billing.
• Perform root cause analysis to address revenue leakage and develop corrective action plans.
• Optimize revenue capture by ensuring all billable services are appropriately charged.
• Ensure adherence to coding guidelines and compliance regulations such as those from CMS.
• Mitigate compliance violations and audits related to billing errors.
• Collaborate with clinical, billing, coding, and IT departments to optimize workflows.
• Coordinate with payers to handle audit requests and review technical denials.
• Educate clinical teams on documentation and charge capture standards.
• Maintain compliance with all HIPAA privacy and security standards.

Qualifications

• 3-5 years of clinical experience is required.
• Strong understanding of medical terminology and patient care.
• Experience in a large not-for-profit or academic health system facility is preferred.
• Proficiency with Epic and medical billing software.
• Extensive knowledge of insurance and governmental programs, and regulations.
• Ability to maintain a high level of positive energy under work demands.

Skills

• Proficiency in EHR systems and audit software.
• Strong analytical, communication, and organizational skills.
• Experience with medical coding systems and healthcare regulations.
• Excellent interpersonal skills and ability to work with senior management.

Additional Requirements

4x a week on site, regular business hours.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

As an equal opportunity employer, Medix is committed to diversity and inclusion. We prohibit discrimination or harassment on the basis of race, color, religion, sex, age, national origin, disability, or any other protected characteristic.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients