MaineHealth Corporate
Professional - Nonclinical
Req #: 15757
Fully Remote Schedule
Under the direct supervision of the Regulatory Billing Audit Manager the Regulatory Billing Auditor is responsible for performing selected medical audit reviews and analysis at the MaineHealth system level of clinical and technical records to support acceptable and compliant charging, billing and documentation practices for MaineHealth and its subsidiaries. This position demonstrates knowledge and experience within defined areas of regulatory billing, such as outpatient and physician practice billing, and works with the Regulatory Billing Manager and Senior Billing Auditors to expand their expertise to the full range of audits. The Auditor provides a statistical report of findings and analysis in the form of an Executive Summary and may participate in communicating these finding to key leaders. The Auditor supports the analysis and recommendations that are used to evaluate compliance with the relevant healthcare regulations and provide technical and educational assistance to MaineHealth system leaders and various staff to ensure related process improvement.
Required Minimum Knowledge, Skills, and Abilities (KSAs)
- Education: HS Education required. Secondary coursework in medical billing and coding is preferred.
- License/Certification: Must Possess one or more of the following certifications: CPC, COC, RHIT, RHIA, CCS, or CCS-P. Additional certifications including CPMA, CHC, or CPCO are preferred.
- Experience: Five or more years combined experience in coding, billing, documentation improvement, clinical practice, payer claims adjudication, and/or compliance Two to three years’ experience with medical auditing, research, and chart review is necessary.
Additional Information
With a career at any of the MaineHealth locations across Maine and New Hampshire, you’ll be working with health care professionals that truly value the people around them – both within the walls of the organization and the communities that surround it.
We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow – programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family.
MaineHealth remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential. If you’re looking to build a career in a place where people help one another deliver best-in-class care, apply today.
