Senior Coding Compliance Auditor - Outpatient

About the role

The Senior Coding Compliance Auditor will assist with the development and execution of the Annual Compliance Workplan including the Auditing and Monitoring Workplans. They will lead & complete detailed Coding compliance audits including complex audits, implement Management Action Plans, prepare high quality audit reports, establish and maintains an Audit the Auditor Quality program, coaches and mentors new and existing Coding auditors, and participate in other compliance program related activities.

Responsibilities

• Conduct detailed coding auditing and monitoring activities on acute side.
• Analyze audit findings to identify discrepancies, trends, patterns which may lead to potential non-compliance and develop well thought actionable recommendations to mitigate associated risks, and partner with the service line leaders to develop and validate Management Action Plans.
• Create and maintain an Audit the Auditor program to monitor quality and identify opportunities for improvement related to audit management tools as well as audit processes.
• Create and maintain training material for Audit process and how to use the Audit Management tool/platform. And leverage it to provide training, education, and ongoing support to the auditors.
• EFFECTIVELY and TIMELY communicate coding compliance concerns to Compliance leadership through identifying trends and patterns.
• Serve as a resource for Coding leaders on compliance audits related questions and concerns.
• Create and maintain Compliance audit records, analytical reports, and track and trend compliance audit program activities; manage compliance audit program issue logs and dashboards.
• Maintain accurate, complete, and up-to-date compliance documents and records and produce for Compliance leadership upon request.
• Afford assistance with onboarding of the new Compliance coding auditors and serve as a resource for the auditors to address their questions/concerns.
• Foster a culture of compliance and continuous improvement within the department and the organization.
• Afford assistance with assessing the Compliance audit program on ongoing basis to identify opportunities for process improvement.
• Contribute to the achievement of Compliance Department goals and objectives and adhere to departmental policies, procedures, and standards; comply with organizational policies and procedures, governmental laws and regulations and accreditation standards.
• Effectively maintain open, effective, and collaborative working relationships with internal and external stakeholders.
• Afford assistance with work assignment of the auditors and follow up on deliverables to ensure deadlines are met.
• Afford assistance with the development and preparation of the annual risk assessment and work plan.
• Help evaluate the adequacy and effectiveness of internal and operational controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to corporate integrity and compliance.
• Participate in other projects as assigned and complete tasks within requested timeframes.

Requirements

• 5-7+ years of experience in healthcare, acute coding, Compliance, audits, or related field.
• ICD-10, DRG, CPT & HCPCS coding knowledge to include Acute Outpatient and Inpatient experience.
• Revenue cycle operations, Compliance standards, auditing standards knowledge.
• Epic, Cerner, and/or Meditech knowledge.
• Basic Word & Excel knowledge.
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.

Qualifications

• Must have and keep current at least one of the following professional certifications (CCS preferred): CPC (Certified Professional Coder), CCS (Certified Coding Specialist), RHIA (Registered Health Information Administrator), RHIT (Registered Health Information Technician).
• Bachelor's degree or equivalent experience, Health Records Management/Medical Coding, preferred.

Skills

• Valuing Differences - Works effectively with individuals of diverse cultures, interpersonal styles, abilities, motivations, or backgrounds; seeks out and uses unique abilities, insights, and ideas.
• Collaboration - Works cooperatively within teams and partners with others, both internally and externally as needed, to achieve success; focuses on the results of the team, not the achievements of one person.
• Accountability - Accepts personal responsibility and/or consequences of failure and successes, delivering on commitments and refocusing effort when needed. Someone who is willing to step up and own it.
• Time Management - Effectively manages personal time and resources to ensure that work is completed efficiently.
• Developing Trust - Gains others' confidence by acting with integrity and following through on commitments; treats others and their ideas with respect and supports them in the face of challenges.
• Takes Initiative - Takes prompt action to accomplish goals and achieve results beyond what is required; is proactive and pursues relentlessly.

Benefits

Commensurate with experience.

Pay

This position pays between $76,300 - $131,550 based on experience.

Schedule

Commensurate with experience.