Billing Compliance Auditor

Elara Caring

76d

About The Position

At Elara Caring, we have a unique opportunity to play a huge role in the growth of an entire home care industry. Here, each employee has the chance to make a real difference by carrying out our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right Time, in the Right Place. The Billing Compliance Auditor performs comprehensive audits within the Skilled Home Health, Hospice, Behavioral Health, and Personal Care Services (PCS) agencies at Elara Caring to ensure compliance with Medicare and Medicaid regulations and billing rules. Areas of focus for audits will include, but are not limited to eligibility, billing, coding, and clinical documentation. Duties of the Billing Compliance Auditor include but are not limited to: (1) conducting audits in accordance with internal policies and procedures and the annual compliance audit work plan; (2) ensuring accuracy of such audits; (3) providing education to agency personnel based on audit results; (4) assisting agencies with corrective action plan development and follow through, and (5) participating in ongoing training to ensure regulatory competency.

Requirements

• Associate’s degree or higher in Nursing.
• 5 years of experience as a Registered Nurse in Home Health and/or Hospice with coding experience is preferred.
• Certified Homecare Coding Specialist (HCS-D) and/or Certified OASIS Specialist-Clinical (COS-C) is preferred.
• Understanding of Federal and State healthcare laws and regulations pertaining to fraud, waste and abuse prevention and patient privacy rights and protections.
• Demonstrates ability to work effectively across departments or divisions within an organization.
• Exhibits working knowledge of regulations and reimbursement in home health, hospice, personal care services and behavioral health.
• Demonstrates the ability to maintain the confidentiality of sensitive financial, clinical, and operational information.
• Displays patience, courtesy, tact, and kindness.
• Valid driver’s license and insurance.
• Reliable transportation to perform job tasks.

Responsibilities

• Conduct audits in accordance with internal policies and procedures and the annual compliance audit work plan.
• Ensure accuracy of audits.
• Provide education to agency personnel based on audit results.
• Assist agencies with corrective action plan development and follow through.
• Participate in ongoing training to ensure regulatory competency.

Benefits

• Competitive compensation package.
• Tuition reimbursement for full-time staff and continuing education opportunities for all employees at no cost.
• Opportunities for advancement.
• Comprehensive insurance plans for medical, dental, and vision benefits.
• 401(K) with employer match.
• Paid time off, paid holidays, family, and pet bereavement.
• Pet insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees