Compliance Auditor-Educator
About The Position
This position plays a dual role in supporting the organization’s compliance program and ensuring accurate clinical documentation and coding practices. This position is responsible for conducting audits, providing educational feedback to the providers from audited batches to ensure compliance with coding and billing requirements established by the payors, and supporting the development and implementation of compliance initiatives that align with federal and state regulations, payer requirements, and internal policies. This position keeps Supervisor and Manager informed of daily progress and issues related to hospital and professional coding and compliance issues. Responsible for obtaining information for billing staff to follow-up on outstanding claims or recording of charges.
Requirements
- High School Diploma or GED required
- Certified Professional Coder – CPC Certification OR Certified Coding Associate Coder – CCA Certification required
Nice To Haves
- Bachelor’s degree preferred
Responsibilities
- Conducting audits
- Providing educational feedback to providers from audited batches to ensure compliance with coding and billing requirements established by the payors
- Supporting the development and implementation of compliance initiatives that align with federal and state regulations, payer requirements, and internal policies
- Keeping Supervisor and Manager informed of daily progress and issues related to hospital and professional coding and compliance issues
- Obtaining information for billing staff to follow-up on outstanding claims or recording of charges
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
