Compliance Auditor

Description

Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:
The Compliance Auditor plans, schedules, and performs comprehensive internal professional fee audits to include routine and focused audits. Performs detection of documentation, coding, and billing errors as well as collaboration with appropriate stakeholders to ensure correction and/or appropriate response to identified issues. Communicates audit results to providers, coders, management, and other appropriate staff. Develops and delivers provider and coder education. Evaluates the effectiveness of internal controls designed to ensure that processes and practices lead to regulatory compliance with guidelines related to professional fee documentation, coding, and billing. Stays abreast of documentation, coding, and billing regulations and standards and serves as a subject matter expert on interpretation and application of documentation and coding rules and regulations.

Responsibilities:
• Plans, schedules, and performs comprehensive internal professional and hospital fee audits as determined by the Compliance & Privacy Office Work Plan to include routine and focused audits. Detection of documentation, coding, and billing errors as well as collaboration with appropriate stakeholders to ensure correction and/or appropriate response to identified issues.
• Communicates audit results to providers, coders, management, and other appropriate staff and makes recommendations to ensure sustained improvement.
• Develops and delivers provider and coder education.
• Evaluates the effectiveness of internal controls designed to ensure that processes and practices lead to regulatory compliance with guidelines related to professional and hospital fee documentation, coding, and billing, including federal and state regulations, CMS, and OIG compliance standards.
• Stays abreast of ever-changing documentation, coding, and billing regulations and standards. Serves as subject matter expert on interpretation and application of documentation and coding rules and regulations.
PARDEE

Other information:
Qualifications
Hired applicants will be expected to hold or obtain an accredited auditing certification.
Required
• Must have 5 years' experience as a coder in a hospital or clinic environment
• Extensive knowledge of evaluation and management coding, modifiers, provider-based billing, and auditing principles
• Strong verbal and written communication skills
• AAPC coding certification (such as CPC)
Preferred
• Three (3) years auditing experience in a hospital or clinic environment
• Auditing certification, CPMA or other accredited auditing certification
01.9593.1545

Job Details

Legal Employer: Pardee - HCHC

Entity: Pardee UNC Health Care

Organization Unit: Compliance

Work Type: Full Time

Standard Hours Per Week: 40.00

Work Schedule: Day Job

Location of Job: PARDEEHOSP

Exempt From Overtime: Exempt: Yes