Compliance Auditor

Medical University of South Carolina • Charleston, SC

2d • Onsite

About The Position

The Compliance Auditor reports to the Internal Audit Coordinator and performs audits to evaluate adherence to laws, regulations and policies by reviewing records, analyzing data, and interviewing staff and stakeholders. These audits include but are not limited to services identified as high-risk via the annual risk assessment, OIG-CMS-PGBA workplan areas, ad hoc audit requests, and “for cause” coding and billing concerns. The audit scope includes a) the regulatory and industry research needed for audit planning, b) pre and post audit meetings with stakeholders, c) cohesive audit report that communicates results and includes a corrective action plan if warranted, and d) education and training to stakeholders as needed.

Requirements

• Bachelor's degree in a related field and a minimum of 2 years of medical billing, coding, and or audit experience OR high school diploma or equivalent (GED) and 4 years of medical billing, coding, and or audit experience required.
• Applicant must be credentialed as a coder or similar professional body (RN, RHIA, CPC, etc.) that lends to compliance auditing.
• Effective oral and written communication skills required.
• Ability to perform job functions while standing (Frequent).
• Ability to perform job functions while sitting (Frequent).
• Ability to perform job functions while walking (Frequent).
• Ability to climb stairs (Infrequent).
• Ability to work indoors (Continuous).
• Ability to work from elevated areas (Frequent).
• Ability to work in confined/cramped spaces (Infrequent).
• Ability to perform job functions from kneeling positions (Infrequent).
• Ability to bend at the waist (Frequent).
• Ability to squat and perform job functions (Infrequent).
• Ability to perform repetitive motions with hands/wrists/elbows and shoulders (Frequent).
• Ability to reach in all directions (Frequent).
• Possess good finger dexterity (Continuous).
• Ability to fully use both legs (Continuous).
• Ability to fully use both hands/arms (Continuous).
• Ability to lift and carry 15 lbs. unassisted (Infrequent).
• Ability to lift/lower objects 15 lbs. from/to floor from/to 36 inches unassisted (Infrequent).
• Ability to lift from 36 inches to overhead 15 lbs (Infrequent).
• Ability to maintain 20/40 vision, corrected, in one eye or with both eyes (Continuous).
• Ability to see and recognize objects close at hand or at a distance (Continuous).
• Ability to match or discriminate between colors (Continuous) (Selected Positions).
• Ability to determine distance/relationship between objects; depth perception (Continuous).
• Ability to maintain hearing acuity, with correction (Continuous).
• Ability to perform gross motor functions with frequent fine motor movements (Continuous).
• Ability to work in a latex safe environment (Continuous).
• Ability to maintain tactile sensory functions (Frequent) (Selected Positions).
• Ability to maintain good olfactory sensory function (Frequent) (Selected Positions).
• Ability to be qualified physically for respirator use, initially and as required.

Nice To Haves

• College degree preferred.

Responsibilities

• Perform audits to evaluate adherence to laws, regulations and policies by reviewing records, analyzing data, and interviewing staff and stakeholders.
• Conduct audits for services identified as high-risk via the annual risk assessment, OIG-CMS-PGBA workplan areas, ad hoc audit requests, and “for cause” coding and billing concerns.
• Conduct regulatory and industry research needed for audit planning.
• Facilitate pre and post audit meetings with stakeholders.
• Prepare cohesive audit reports that communicate results and include a corrective action plan if warranted.
• Provide education and training to stakeholders as needed.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level