Revenue Assurance - Auditing Analyst

Job description

**Role Overview** The Revenue Assurance Internal Audit role is responsible for **ensuring accuracy, completeness, and integrity of hospital revenue** by identifying leakages, strengthening billing controls, and improving revenue cycle processes. The role works closely with operations, billing, and clinical teams to **minimize revenue loss and ensure compliance with hospital policies and payer guidelines**. **Key Responsibilities** **1. Revenue Audit & Control** - Conduct **regular internal audits** across OPD, IPD, Pharmacy, Laboratory, and Radiology billing. - Ensure **all services rendered are accurately captured and billed** (charge capture validation). - Identify instances of **under-billing, missed charges, or incorrect billing**. **2. Billing Accuracy & Compliance** - Review **patient bills, packages, tariffs, and discounts** for adherence to hospital policies. - Validate **package inclusions/exclusions and billing accuracy**. - Ensure compliance with **insurance, TPA, and corporate billing guidelines**. **3. Revenue Leakage Identification** - Analyze data to identify **revenue gaps, leakages, and process inefficiencies**. - Highlight areas of **missed revenue opportunities and financial risks**. - Recommend corrective and preventive actions to **plug revenue leakages**. **4. Process Improvement & SOP Implementation** - Conduct **process audits** and identify gaps in revenue cycle management. - Develop and implement **standard operating procedures (SOPs)** for billing and revenue assurance. - Work with departments to improve **charge capture and documentation practices**. **5. Stakeholder Coordination** - Collaborate with **billing, operations, consultants, nursing, pharmacy, and diagnostics teams**. - Ensure timely resolution of **audit observations and discrepancies**. - Support teams in improving compliance and billing accuracy. **6. Reporting & Analytics** - Prepare **audit reports, dashboards, and revenue analysis** for leadership. - Track **key metrics such as revenue leakage, recovery, and billing accuracy**. - Provide insights and recommendations for **continuous improvement**. **7. Training & Awareness** - Conduct training sessions for staff on **billing accuracy, documentation, and compliance**. - Create awareness on **common errors and best practices in revenue cycle management**.