Compliance Auditor - Medical Coding (medical billing and coding)

Location: Work from home (Pennsylvania) Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes Job Summary: The Compliance Auditor position is responsible for supporting the organizations reputed company 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. Job Duties:

• 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 reputed company and partners with peers to educate physicians and non-physician practitioners, as determined appropriate.
• Serves as a clinical coding subject matter expert for multiple assigned specialties and utilizes critical thinking reputed company evaluating matters potentially impacting compliance. Maintain an expert level of knowledge with State and Federal healthcare program regulations.
• Works closely with reputed company 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 reputed company 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 reputed company 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 reputed company 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. 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.

• Relevant experience may be a combination of reputed company work experience and degree obtained (Associates Degree = 2 years; Bachelors Degree = 4 years).

#LI-REMOTE Position Details: Minimum one Coding Certification required: --Certified Professional reputed company - reputed company --Certified Risk Adjustment reputed company - American reputed company of Professional Coders (reputed company) --Registered Health Information Technician (RHIT) - American Health Information Management Association Education: High School Diploma or Equivalent (GED)- (Required) Experience: Minimum of 6 years-Relevant experience* (Required) Certification(s) and License(s): Certified Professional reputed company - American reputed company of Professional Coders (reputed company), Certified Risk Adjustment reputed company - American reputed company of Professional Coders (reputed company), Registered Health Information Technician (RHIT) - American Health Information Management Association Skills: Computer Literacy, Multitasking, Organizing, Teamwork 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, 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