Analyst Government Audit & Denials

Responsibilities: #HireNRHSResponsible for reviewing government audit requests, denial notification and charge audits are received and properly routed for efficient response, compliance, appeal completion, and reimbursement/revenue integrity. Responsible for coordinating and reporting of  RAC, MAC, Targeted Probe and Educate, ZPIC, OIG and other Government Audit activity.Functions as the primary Government Audit liaison for NRHS departments: Patient Financial Services, Health Information Management, Utilization Review, Medical Staff, Compliance Committee, Internal Audit, and other clinical departments, as well as the Oklahoma RAC contractor, CMS, Oklahoma's Medicare intermediary, and managed care payers.Completes and Compiles reporting for to Finance Committee, Compliance Committee, Billing Compliance Committee, and Denials Committee, Executive Team and Board and others as needed. Qualifications: EducationHigh School diploma or equivalent. Completion of Medical Terminology Course. Prefer some post high school education in related field such as Accounting and/or Business Communications. Required:  Excel/MS Word skills in word processing and spreadsheets creation and maintenance. Required:  Completion of Medical Terminology.ExperienceThree years of experience in Medicare, Medicaid, third-party billing, and compliance and reimbursement regulations required. A minimum of seven years’ experience in medical auditing, hospital Patient Accounting office experience Minimum of 3 years’ experience in hospital Medicare/Medicaid/third party billing and collections.  Minimum of 3 years’ experience with charge auditing, CPT/HCPC and Revenue coding review.  Experience in reporting in Excel, Word and data entry.  Experience in navigating Electronic Health Records.  Licensure/CertificationAdvanced coding certification (Certified Coding Specialists (CCS - Issued by American Health Information Mgmt Assoc - AHIMA, CPC, CPC-H, RHIT, or RHIA) preferred.Compensation$19.00-$30.71/hr based on previous work experienceBenefits include medical, dental, vision, short-term disability, long-term disability, life insurance, paid time off (PTO), paid holidays, tuition reimbursement, scholarship opportunities, retirement plans, free parking, and opportunities for advancement 

Created: 2025-07-02