Enovis | Audit Specialist | jersey city, nj

Job Description: At Enovisâ„¢ we pay attention to the details. We embrace collaboration with our partners and patients, and take pride in the pursuit of scientific excellence - with the goal of transforming medical technology as we know it. Because that's how we change the lives of patients for the better. And that's how we create better together. Why work at Enovis? See for yourself. As a key member of the Revenue Cycle Management team, you will play an integral part in helping Enovis drive the medical technology industry forward through transforming patient care and creating better patient outcomes. Job Title : Audit Specialist Reports To : Manager, RCM Billing Operations Location: West Orange, NJ Business Unit Description : Revenue Cycle Management Job Title/High Level Position Summary : Audit Specialists perform various tasks associated with the billing and collections audits of Accounts Receivable. Responsible for ensuring that all appropriate billing charges are captured, documented, charged, and reimbursed according to policies and procedures and applicable regulatory standards and requirements for the assigned department. Plan, conduct, and evaluate reviews and audits of clinical documentation and billing practices for conformity with relevant regulatory requirements. Identify proactive opportunities to enhance regulatory compliance and facilitate appropriate billing practices. Responds to third-party audits and charge recovery vendor solution audits. Key Responsibilities : Demonstrates exceptional service and integrity related to customer accounts through accurate, timely, relevant, and quality work efforts of all Accounts Receivable or assigned tasks. Assists in the development and implementation of action plans to mitigate risk, pertaining to revenue cycle processes and billing compliance. Weekly audit of insurance charges and manage AR escalations. Reviews and prepares audit documentation and submits within timely manner to appropriate auditing entity. Performs collections for RCM Department related to cash collections, aged accounts receivables, and denials. Reviews claims with outstanding balances and identifies actions to successfully collect revenues. Presents unresolved patient concerns to Management for escalation and resolution. Follows up with insurers and patients to collect outstanding balances while providing exceptional customer service focused on building enduring business relationships. Other duties as assigned. Hybrid Role - Tuesday, Wednesday and Thursday On Site at local location Compliance: Demonstrates commitment to the Compliance & Ethics Program, the Enovis Code of Conduct, the Enovis Sales and Marketing Code of Conduct, the AdvaMed Code of Ethics, and all supporting and applicable regulations, policies, and procedures. Adheres to all internal Corporate Compliance guidelines, OIG, government healthcare regulations, regulatory policies and procedures, and privacy and security standards in accordance with government agencies, including HIPAA requirements. Treats Protected Health Information (PHI) with the strictest confidentiality in accordance with HIPAA standards. Acquires a basic understanding of the field to include regulatory compliance issues and adheres to these guidelines. Minimum Basic Qualifications : Minimum of 5 years of experience medical billing and collections required. Proficiency in Microsoft Office applications required. Knowledge of billing and collections regulations strongly preferred. Experience in a healthcare environment strongly preferred. Demonstrated customer service expertise. Education: High School Diploma or GED required. Travel Requirements: This position does not require travel. Desired Characteristics : Knowledge of insurance contract practices, third-party billing and billing to private clients strongly preferred. Experience using Dataworks, Computers Unlimited TIMS, or similar third-party billing software strongly preferred. "Creating better together". It's the Enovis purpose, and it's what drives us and empowers us every day on a global scale. We know that the power to create better - for our customers, our team members, and our shareholders - begins with having the best team, pursuing common goals, operating at the highest levels, and delivering extraordinary outcomes. Watch this short video and discover what creating better together means to us at Enovis: Our Enovis Purpose, Values and Behaviors on Vimeo We offer a comprehensive benefits package that includes: Medical Insurance Dental Insurance Vision Insurance Spending and Savings Accounts 401(k) Plan Vacation, Sick Leave, and Holidays Income Protection Plans Discounted Insurance Rates Legal Services ABOUT ENOVIS Enovis Corporation (NYSE: ENOV) is an innovation-driven medical technology growth company dedicated to developing clinically differentiated solutions that generate measurably better patient outcomes and transform workflows. Powered by a culture of continuous improvement, global talent, and innovation, the company's extensive range of products, services, and integrated technologies fuels active lifestyles in orthopedics and beyond. Visit to learn more. EQUAL EMPLOYMENT OPPORTUNITY Enovis provides equal employment opportunities based on merit, experience, and other work-related criteria without regard to race, color, ethnicity, religion, national origin, sex, age, pregnancy, disability, veteran status, or any other status protected by applicable law. We also strive to provide reasonable accommodation to employees' beliefs and practices that do not conflict with Enovis policies and applicable law. We value the unique contributions that every employee brings to their role with Enovis. Join us in creating better together. ABOUT ENOVISâ„¢ Enovis Corporation (NYSE: ENOV) is an innovation-driven medical technology growth company dedicated to developing clinically differentiated solutions that generate measurably better patient outcomes and transform workflows. Powered by a culture of continuous improvement, global talent and innovation, the Company's extensive range of products, services and integrated technologies fuels active lifestyles in orthopedics and beyond. For more information about Enovis, please visit EOE AA M/F/VET/Disability Statement All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of race, religion, color, national origin, sex, protected veteran status, disability, or any other basis protected by federal, state or local laws.

Created: 2024-11-28