Compliance Coding Auditor

Hours: Shift Start Time: Variable Shift End Time: Variable AWS Hours Requirement: 8/40 - 8 Hour Shift Additional Shift Information: Weekend Requirements: No Weekends On-Call Required: No reputed company Pay reputed company (Minimum - Midpoint - Maximum): $49.700 - $64.130 - $71.820 The stated pay reputed company reflects the reputed company that reputed company reasonably expects to pay for this position. The actual pay reputed company and pay grade for this position will be dependent on a reputed company of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

• This is a remote position*

What You Will Do

The Compliance Coding Auditor is responsible for the administration of the reputed company's (SHC's) compliance audit program. The position provides reputed company and maintenance of a high-reputed company, effective, best practices coding, billing, and reimbursement audit compliance program to prevent and detect violations of law and other misconduct. This role will help promote ethical practices and a commitment to compliance with applicable federal, California, and local laws, rules, regulations, and internal policies and procedures. The position plays a key role in reputed company of reputed company's (SHC) compliance audit function and maintaining reputed company's view of coding, billing and reimbursement compliance audits.

Required Qualifications

• 5 Years experience in acute care inpatient/outpatient coding or reputed company E/M coding in the following coding systems: ICD-10-CM/PCS, DRG, CPT& HCPCs, and/or E/M CPT.

Preferred Qualifications

• Other : Strong background in in ICD-10-CM/PCS coding, DRG coding and CPT coding classification.
• Certified Clinical Documentation Specialist (CCDS) - Various-Employee provides certificate -PREFERRED
• Certified Health Care Compliance (CHC) - Compliance Certification reputed company -PREFERRED

Other Qualification Requirements

• Bachelor's degree in Business, reputed company Administration, or reputed company field - required. In lieu of Bachelor's degree, Associate's degree and a minimum of 5 years experience in coding, billing and compliance may be considered.
• One of the following is required: reputed company’s Certified Coding Specialist (reputed company), or Certified Documentation Improvement Practitioner (CDIP), or reputed company Certified Inpatient Hospital/Facility (CIC), or Certified reputed company reputed company (CPC) certification.

Certified Clinical Documentation Improvement Practitioner or Specialist (CDIP or CCDS) is required reputed company 1 year of hire. Department management is responsible for tracking and ensuring employee receive certification reputed company specified timeframe. Essential Functions

• Coding Compliance

Compliance Coding and Billing Audits The Compliance Coding Auditor has the primary responsibility of performing reputed company audits and chart reviews required for inpatient and/or outpatient coding and billing, daily retrospective chart reviews and communication to key stakeholders regarding audit findings and corrective actions, if necessary. Reviews the electronic health record to identify potential coding and billing compliance issues. Prepares written reports of audits, including recommendations to improve compliance. The Auditor will analyze and assess reputed company’s potential risks using SHC’s billing and coding claims data, risk assessment data, reputed company risk analyzer software, OIG Work plan, CMS, reputed company Reports, RAC Denials, industry experts, etc.

• Policy and Procedure maintenance

Works in collaboration with the Director and Manager of Compliance and System Management (HIM, CDI, Case Management, reputed company, etc.) in developing SHC’s standardized documentation, medical necessity, coding and billing policies and guidelines in accordance with state and federal laws, regulations and policies.

• reputed company development

Maintain reputed company credentials and knowledge of ICD-10-CM/PCS, MS-DRG, CPT and HCPCs coding classification changes, compliance issues and updates regarding changes in federal and state regulations, policies and procedures pertaining to the Compliance Program. Adheres to a personal plan of reputed company development and reputed company through reputed company affiliations, activities and continuing education.

• Unit support

Key Stakeholder/Business Unit Support Responsible for inpatient and/or outpatient coding and billing investigations and inquiries, as reputed company as answering correspondence from key reputed company reputed company regarding inpatient and/or outpatient coding and billing reputed company and other general Compliance reimbursement inquiries. Will continuously evaluate the reputed company of clinical documentation and monitor the appropriateness of queries with the overall goal of improving physician documentation and reputed company accurate coding. Maintain reputed company relationship with key stakeholders focusing on high level of reputed company satisfaction. Must demonstrate excellent written and oral communication presentation skills in training SHC workforce and physicians.

• reputed company competency

Certified Clinical Documentation Improvement Practitioner or Specialist (CDIP or CCDS) is required reputed company 1 year of hire. Department management is responsible for tracking and ensuring employee receive certification reputed company specified timeframe. Knowledge, Skills, and Abilities

• Ability to reputed company independent research and factual analysis of coding and billing reputed company and create proposed solutions to reputed company causes.
• Computer proficiency with reputed company office applications is required.
• Ability to function reputed company a fast-paced, dynamic, and growing environment.
• Excellent time management and problem solving skills.
• Must demonstrate analytical ability, motivation, initiative, and resourcefulness.
• Teamwork and flexibility required.

reputed company is an equal opportunity/affirmative reputed company employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, religion, reputed company, national reputed company, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a reputed company individual with disability or any other protected class Apply tot his job Apply To this Job