Coding & Documentation Compliance Auditor

Responsibilities

• Conducts audits in accordance with the approved Revenue Compliance Work Plan or as requested by the Manager or Director.
• Maintains organized files to support audit observations and drafts related audit reports in accordance with agreed upon standards in a timely manner.
• Collaborates with business owner to develop agreed-upon action plans to address findings identified during an audit.
• Communicates audit results and corrective action plans to audit stakeholders.
• Makes sure corrective action plans are implemented as intended.
• Stays updated on documentation, coding and billing regulations and requirements via professional organizations and through independent research and education on payor rules, requirements and regulatory guidelines (HHS/OIG, Medicare, Medicaid, NGS, Commercial Insurers, etc).
• Assists with review and/or investigation of Compliance Line reports as requested by the Manager or Director.
• Assists with the development and revision of HHC and Department Policies and Procedures.
• Participates in the annual and ongoing risk assessments to develop and revise the Revenue Compliance Work Plan.

Qualifications

• Education: Bachelor’s Degree Required
• Experience: A minimum of two (2) years of health care compliance experience, preferably in a large Healthcare system setting or in a consulting capacity.
• Certified Professional Coder (CPC) certification strongly preferred