What are the responsibilities and job description for the CLINICAL COMPLIANCE AUDITOR position at Southern Illinois Healthcare?
Your Career. Our Company. Together, We Grow.
At Southern Illinois Healthcare (SIH), we realize that in order to provide our surrounding communities with excellent care, we must begin by providing our employees with that same care and appreciation. We offer rich opportunities to develop and grow professionally, an environment of excellence in patient care, and the awareness that everything we accomplish is a direct outgrowth of the superb efforts and dedication of our employees.
As a non-profit system of almost 4000 employees, we have won national acclaim for our cancer, cardiac, stroke, bariatric, breast imaging, and rehabilitation services.
Responsible for performing appraisal activities, including quality and compliance reviews of physician coding, documentation, and billing practices.
Responsibilities
- Plans and performs audits and investigations focused on detecting and preventing fraud and abuse and prepares written reports of findings and recommendations.
- Provides feedback and education regarding audit findings.
- Provides support for the development of corrective actions for deficiencies.
- Responds to inquiries from patients, physicians and staff.
- Conducts trend analysis.
- Reviews requests from government agencies, payors and patients.
- Conducts compliance education.
- Produces periodic compliance newsletter for staff, including physicians.
- Assists with external audits, investigations, and appeals.
- Bachelor’s degree, RN, RHIT, or RHIA
- Professional coding certification or RHIT/RHIA obtained within 6 months of hire
- Technical Experience: 3 years with degree, OR 8 years of experience without bachelor’s degree
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