Compliance Auditor

Position Summary

The Compliance Auditor shall be responsible for conducting audits to determine the accuracy of documentation and related processes in accordance with laws, regulations, program service description, policies and payer requirements.

Responsibilities

• Identify compliance concerns and trends to support the development of the annual Compliance Audit Plan
• Perform focused audits based on data mining and analytic findings
• Complete retrospective reviews of service documentation to ensure claims meet payer requirements
• Collect, analyze, interpret, and document information to support audit findings
• Summarize audit findings into formal reports, detailing audit conclusions, and determining recommendations
• Coordinate monitoring of coding and documentation accuracy
• Perform educational training programs consisting of appropriate documentation guidelines and accurate coding to all appropriate personnel
• Maintain abreast of compliance issues related to the healthcare industry, annual coding updates and frequent regulatory changes
• Recommend changes to policies, processes, or procedures

Requirements

• Bachelor's Degree required
• Experience providing services in a healthcare related field, required
• Experience auditing charts, both in the field and in an Electronic Health Record, required
• This is a remote position with 25% travel required for onsite audits
• Position is available for candidates residing in PA, DE, NJ, and VA

Preferred Qualifications

• Experience with RATS-STATS and/or similar sampling software
• A demonstrated ability to prioritize and effectively complete tasks in a timely manner
• Technical and database management abilities

Pay

$26.72 - $29.26 / hour (depending on experience)

Benefits

• Comprehensive medical, dental, and vision coverage, plus access to healthcare advocacy support
• Retirement plan -- both pre-tax and Roth (after-tax) options available for employee contributions
• DailyPay -- access your pay when you need it
• On the Goga well-being platform, featuring self-care tools and resources
• Access Care.com for backup childcare, elder care, and household services
• Confidential counseling, legal, and financial services through our Employee Assistance Program (EAP)
• Tuition reimbursement and educational partnerships
• Employee discounts and savings programs on entertainment, travel, and lifestyle
• Access to Pryor Online Learning for free online personal development classes

About Merakey

Merakey is a non-profit provider of developmental, behavioral health, and education services. More than 8,000 employees provide support to nearly 40,000 individuals and families throughout 12 states across the country each year.