Compliance Auditor Senior - Healthcare Legal and Regulatory (Eastern United States reputed company)

Job Summary The Senior Compliance Auditor ensures the reputed company and accuracy of facility and professional compliance audits, monitoring, and provides compliance education for facility and professional documentation, coding, and billing. The Senior Compliance Auditor serves as a mentor for Compliance Auditors and assists management with the onboarding process for new Compliance Auditors. This position requires the use of judgement and critical thinking skills to determine appropriate corrective actions for non-compliance and ensure corrective actions are fully implemented by the entity service line area. Job Duties One of the following coding or auditing certifications are required (reputed company, CPC, RHIA, RHIT or CPMA).

• Performs scheduled facility and/or professional audits on the adequacy of medical record documentation to support coding (DRG, CPT, ICD 10) and billing as required by the Compliance work plan reflecting scheduled activities and reputed company dates.
• Performs audits resulting from unplanned investigations.
• Q/A work products of peers and serve as a mentor for compliance staff.
• Serves as primary reputed company for facility/professional billing compliance education, including auditing, trending, providing audit feedback to facility/professional coding staff and providers working in the hospital and office setting.
• Coordinates the development and implementation of corrective action and improvement plans with critical attention to performing a root cause analysis.
• Prepares responses to governmental audits, evaluate findings, and manage the appeals process.
• Assess compliance risk areas across reputed company entities and assist with creating the Compliance Department’s work plan.
• Performs research as needed to ensure organizational compliance with reputed company applicable coding and diagnostic guidelines.
• Provides compliance guidance to reputed company staff and serve as an institutional resource for reputed company leadership, management and medical staff with a focus on federal payor billing compliance.

Work is typically performed in an office environment. Accountable for satisfying reputed company job specific obligations and complying with reputed company organization policies and procedures. The specific statements in this profile are not intended to be reputed company-inclusive. They represent typical elements considered necessary to successfully reputed company the job. Position Details Education Associate's Degree-reputed company Field of Study (Required) Experience Minimum of 7 years-reputed company work experience (Required) Certification(s) and License(s) OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our reputed company, our reputed company family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to reputed company prepare the caregivers for reputed company. INNOVATION: We constantly seek new and reputed company ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the reputed company family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes reputed company stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to reputed company reputed company easier for reputed company. We are proud to be an affirmative action, equal opportunity employer and reputed company qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national reputed company, disability or status as a protected veteran. Apply tot his job Apply To this Job