Medical Billing Compliance Auditor
About The Position
Under general supervision, ensures that compliance initiatives are met for all the NorthStar client sites. The Medical Billing Compliance Auditor is responsible for investigating potential compliance issues linked to clinical and billing activities. This person will support the compliance team by performing quality, internal audits and monitoring essential services in compliance with federal and state laws and regulations. Qualifications NorthStar Anesthesia is a company of caregivers, founded by an anesthesiologist and a Certified Registered Nurse Anesthetist (CRNA). With more than 4,000 anesthesiologists and CRNAs under its banner, NorthStar partners with more than 280 client sites across over 20 states and counting to deliver a more productive and efficient model of anesthesia care. Its "care team" approach focuses on the provision of high-quality care while measurably improving operating room performance. To review our corporate opportunities, click here.
Requirements
- 1 to 3 years applicable compliance experience, in healthcare industry preferred.
- CPC certification required
Nice To Haves
- 4 years of healthcare billing and coding experience preferred.
- Excel and Power Point knowledge preferred
Responsibilities
- Coordinates with Compliance Director and Chief Compliance Officer on any billing compliance investigations.
- Reviews and audits documentation in the medical records and charges submitted including CPT and ICD-10 information to ensure compliance.
- Reviews charge information, claim forms, and insurance correspondence to determine if coding, billing, claim follow-up, payment receipts, posting activities, and credit processing are being performed in an accurate and timely manner and is supported by documentation.
- Analyzes billing trends to identify areas of non-compliance and prepares regular reports on audit findings to Compliance Director.
- Collaborates with the Compliance Team to develop annual audit work plans.
- Educates providers when deficiencies in documentation and code selection are identified.
- Develops corrective action plans and participates in compliance investigations as needed.
- Promote NorthStar Anesthesia’s Core Values.
- Demonstrates regular, reliable and predictable attendance.
- Performs other duties as required.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
