Compliance Auditor

Merakey • Whitemarsh Township, PA

1d • $27 - $29 • Remote

About The Position

The Compliance Auditor shall be responsible for conducting audits to determine the accuracy of documentation and related processes in accordance with laws, regulations, program service description, policies and payer requirements. The Compliance Auditor will identify compliance concerns and trends to support the development of the annual Compliance Audit Plan, perform focused audits based on data mining and analytic findings, and complete retrospective reviews of service documentation to ensure claims meet payer requirements. The role involves collecting, analyzing, interpreting, and documenting information to support audit findings, summarizing these findings into formal reports with conclusions and recommendations, and coordinating monitoring of coding and documentation accuracy. Additionally, the Compliance Auditor will perform educational training programs on documentation guidelines and accurate coding, stay updated on compliance issues in the healthcare industry, annual coding updates, and regulatory changes, and recommend policy, process, or procedure changes.

Requirements

• Bachelor’s Degree required
• Experience providing services in a healthcare related field, required
• Experience auditing charts, both in the field and in an Electronic Health Record, required

Nice To Haves

• Experience with RATS-STATS and/or similar sampling software.
• A demonstrated ability to prioritize and effectively complete tasks in a timely manner.
• Technical and database management abilities.

Responsibilities

• Identify compliance concerns and trends to support the development of the annual Compliance Audit Plan
• Perform focused audits based on data mining and analytic findings
• Complete retrospective reviews of service documentation to ensure claims meet payer requirements
• Collect, analyze, interpret, and document information to support audit findings
• Summarize audit findings into formal reports, detailing audit conclusions, and determining recommendations
• Coordinate monitoring of coding and documentation accuracy
• Perform educational training programs consisting of appropriate documentation guidelines and accurate coding to all appropriate personnel
• Maintain abreast of compliance issues related to the healthcare industry, annual coding updates and frequent regulatory changes
• Recommend changes to policies, processes, or procedures

Benefits

• Comprehensive medical, dental, and vision coverage, plus access to healthcare advocacy support.
• Retirement plan -- both pre-tax and Roth (after-tax) options available for employee contributions.
• DailyPay -- access your pay when you need it!
• On the Goga well-being platform, featuring self-care tools and resources.
• Access Care.com for backup childcare, elder care, and household services.
• Confidential counseling, legal, and financial services through our Employee Assistance Program (EAP).
• Tuition reimbursement and educational partnerships.
• Employee discounts and savings programs on entertainment, travel, and lifestyle.
• Access to Pryor Online Learning for free online personal development classes.

What This Job Offers

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