Staff Coding Compliance Auditor, Medical Billing and Coding

Job Description: • The Compliance Auditor position is responsible for supporting the organization’s Revenue Management Compliance department in developing, implementing, and administering an effective compliance program • Accurately audits and provides compliance research support to physicians, non-physician practitioners, leadership, and administrative staff on documentation and coding requirements • Determines the adequacy of medical record documentation, coding, and billing, using established compliance auditing and research guidelines for hospital and professional services • Performs compliance audits to determine the adequacy of medical record documentation, billing, and coding, utilizing policies, procedures, Federal and State laws, regulations, and standard coding guidelines • Evaluates whether documentation and coding patterns present a compliance risk to the organization and provides input on recommended solutions • Identifies training and education needs through compliance audit results prepared and partners with peers to educate physicians and non-physician practitioners • Serves as a clinical coding subject matter expert for multiple assigned specialties and utilizes critical thinking when evaluating matters potentially impacting compliance • Works closely with revenue cycle staff to review systems and/or workflows established to ensure compliance with policies, plans, procedures, laws and regulations • Reviews service line operations or programs to ascertain whether audit results are consistent with established policies, procedures, procedures, Federal and State regulations • Identifies and defines audit scope and criteria and program of examination for the assigned areas being audited • Responsible for surveying the functions and activities in the assigned areas being audited to determine the nature of operations and adequacy of the system to achieve established objectives • Identifies key control points of assigned areas being audited • Obtains, analyzes, and appraises evidentiary data and available information as a basis for making an informed, objective opinion on the adequacy and effectiveness of systems and the performance of assigned areas being audited • Makes recommendations for improvement and corrective action plans where appropriate • Prepares accurate executive briefs showing the results of assigned areas being audited in accordance with those practices followed within the general scope of the audit parameters • Appraises the adequacy of corrective action taken by management to address findings identified through an external audit engagement • Provides input in the risk assessment process to determine specific areas of focus for compliance risk mitigation as directed by Compliance or Senior Leadership • Work is typically performed in an office environment Requirements: • Minimum one Coding Certification required: --Certified Professional Coder - AAPC--Certified Risk Adjustment Coder - American Academy of Professional Coders (AAPC)--Registered Health Information Technician (RHIT) - American Health Information Management Association • High School Diploma or Equivalent (GED)- (Required) • Minimum of 6 years-Relevant experience* (Required) Benefits: • healthcare benefits for full time and part time positions from day one • vision, dental and domestic partners • atmosphere of collaboration, cooperation and collegiality Apply tot his job