Supervisor, Medical Audit - Medical Bill Audit

Supervises and monitors the daily activities of non-licensed and licensed staff to successfully complete the daily work, maintains contact with the clinical departments to ensure accurate charge capture and works with the CDM analyst to maintain a compliant Charge Master. Works with MBA staff to meet the daily DNB goals and contributes to meeting the Revenue Integrity Department’s and the hospital’s fiscal goals. Supports the efforts of Coding, HIM, Denials, and Utilization Management by ensuring timely, accurate, and complete data entry in multiple information systems/data bases. Assists Patient Accounts by reviewing, correcting and submitting billing information to enable timely filing of bills and maintaining a low AR. Brings issues with legal, risk management, or compliance implication to the attention of Manager or Director in an expedient manner. Functions as key contact point for the Hospital and maintains excellent working relationships with TGH ancillary leadership, payers, physicians, physician advisors, and external Third-Party auditors. Participates in strategic planning for the department, working as a member of the leadership team. Interviews applicants, makes recommendations for hiring and salary for new employees, completes performance appraisals in a timely manner and employs disciplinary actions as required. Represents the department on Committees as indicated. Responsible for performing job duties in accordance with the mission, vision and values of Tampa General Hospital and the principles of quality improvement. Essential Functions: Supervise and monitor daily medical audit operations to ensure DNB and productivity goals are met. Maintain ongoing communication with clinical departments to support accurate and compliant charge capture. Collaborate with the CDM Analyst to maintain and update a compliant Charge Description Master. Support Coding, HIM, Denials, Utilization Management, and Patient Accounts by ensuring accurate and timely data entry across systems. Review, correct, and submit billing information to facilitate timely claim submission and maintain low accounts receivable. Conduct and oversee accurate medical audits in accordance with departmental charge policies and professional audit standards. Identify and escalate legal, compliance, or risk‑related issues to management promptly. Serve as a key liaison with ancillary leadership, payers, physicians, physician advisors, and third‑party auditors. Interview candidates, recommend hiring and salary actions, complete performance appraisals, and administer corrective action as needed. Participate in strategic planning, committees, and quality improvement initiatives while upholding Tampa General Hospital’s mission, vision, and values. Supervises and monitors the daily activities of non-licensed and licensed staff to successfully complete the daily work, maintains contact with the clinical departments to ensure accurate charge capture and works with the CDM analyst to maintain a compliant Charge Master. Works with MBA staff to meet the daily DNB goals and contributes to meeting the Revenue Integrity Department’s and the hospital’s fiscal goals. Supports the efforts of Coding, HIM, Denials, and Utilization Management by ensuring timely, accurate, and complete data entry in multiple information systems/data bases. Assists Patient Accounts by reviewing, correcting and submitting billing information to enable timely filing of bills and maintaining a low AR. Brings issues with legal, risk management, or compliance implication to the attention of Manager or Director in an expedient manner. Functions as key contact point for the Hospital and maintains excellent working relationships with TGH ancillary leadership, payers, physicians, physician advisors, and external Third-Party auditors. Participates in strategic planning for the department, working as a member of the leadership team. Interviews applicants, makes recommendations for hiring and salary for new employees, completes performance appraisals in a timely manner and employs disciplinary actions as required. Represents the department on Committees as indicated. Responsible for performing job duties in accordance with the mission, vision and values of Tampa General Hospital and the principles of quality improvement. Essential Functions: Supervise and monitor daily medical audit operations to ensure DNB and productivity goals are met. Maintain ongoing communication with clinical departments to support accurate and compliant charge capture. Collaborate with the CDM Analyst to maintain and update a compliant Charge Description Master. Support Coding, HIM, Denials, Utilization Management, and Patient Accounts by ensuring accurate and timely data entry across systems. Review, correct, and submit billing information to facilitate timely claim submission and maintain low accounts receivable. Conduct and oversee accurate medical audits in accordance with departmental charge policies and professional audit standards. Identify and escalate legal, compliance, or risk‑related issues to management promptly. Serve as a key liaison with ancillary leadership, payers, physicians, physician advisors, and third‑party auditors. Interview candidates, recommend hiring and salary actions, complete performance appraisals, and administer corrective action as needed. Participate in strategic planning, committees, and quality improvement initiatives while upholding Tampa General Hospital’s mission, vision, and values. Technical Program LPN and/or Associate's Degree in Nursing required. Licensure through the FLDOH as an RN or LPN. Medical Audit Specialist (CMAS) from American Association of Medical Audit Specialists (AAMAS) or Certified Professional Medical Auditor (CPMA) from the American Academy of Professional Coders (AAPC) required. Four (4) years of related experience. Technical Program LPN and/or Associate's Degree in Nursing required. Licensure through the FLDOH as an RN or LPN. Medical Audit Specialist (CMAS) from American Association of Medical Audit Specialists (AAMAS) or Certified Professional Medical Auditor (CPMA) from the American Academy of Professional Coders (AAPC) required. Four (4) years of related experience.

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