Senior Coding Compliance Auditor - Inpatient

Ensemble Health Partners•Work at Home - Illinois - Other, IL

1d•$76,300 - $131,550•Remote

About The Position

The Senior Coding Compliance Auditor will assist with the development and execution of the Annual Compliance Workplan including the Auditing and Monitoring Workplans. They will lead & complete detailed Coding compliance audits including complex audits, implement Management Action Plans, prepare high quality audit reports, establish and maintains an Audit the Auditor Quality program, coaches and mentors new and existing Coding auditors, and participate in other compliance program related activities. The senior auditor is expected to work independently with minimal supervision, will manage projects/initiatives as assigned, use analytical and problem-solving skills to assist the auditors with their complex account reviews.

Requirements

5-7+ years of experience in healthcare, acute coding, Compliance, audits, or related field
ICD-10, DRG, CPT & HCPCs coding knowledge to include Acute Outpatient and Inpatient experience
Revenue cycle operations, Compliance standards, auditing standards knowledge
Epic, Cerner, and/or Meditech knowledge
Basic Word & Excel knowledge
Long-distance or air travel - not to exceed 10% travel
Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences
Candidates must have and keep current at least one of the following professional certifications (CCS preferred): CPC (Certified Professional Coder), CCS (Certified Coding Specialist), RHIA (Registered Health Information Administrator), RHIT (Registered Health Information Technician)
CHC (Certified in Healthcare Compliance) May be obtained at designated time upon acceptance into role

Nice To Haves

Bachelors degree or equivalent experience, Health Records Management/Medical Coding, preferred

Responsibilities

Conduct detailed coding auditing and monitoring activities on acute side.
Analyze audit findings to identify discrepancies, trends, patterns which may lead to potential non-compliance and develop well thought actionable recommendations to mitigate associated risks, and partner with the service line leaders to develop and validate Management Action Plans.
Create and maintain an Audit the Auditor program to monitor quality and identify opportunities for improvement related to audit management tools as well as audit processes.
Provide regular updates to the Compliance leader on audits, MAPs outcomes, and escalate potential compliance concerns which require immediate attention.
Create and maintain training material for Audit process and how to use the Audit Management tool/platform. And leverage it to provide training, education, and ongoing support to the auditors.
Effectively and timely communicate coding compliance concerns to Compliance leadership through identifying trends and patterns.
Serve as a resource for Coding leaders on compliance audits related questions and concerns. Keep up with coding guidelines and industry standards for coding practices.
Create and maintain Compliance audit records, analytical reports, and track and trend compliance audit program activities; manage compliance audit program issue logs and dashboards.
Maintains accurate, complete, and up-to-date compliance documents and records and produce for Compliance leadership upon request.
Assist with onboarding of the new Compliance coding auditors and serve as a resource for the auditors to address their questions/concerns.
Foster a culture of compliance and continuous improvement within the department and the organization.
Assist with assessing the Compliance audit program on ongoing basis to identify opportunities for process improvement. Contribute to the achievement of Compliance Department goals and objectives and adhere to departmental policies, procedures, and standards; comply with organizational policies and procedures, governmental laws and regulations and accreditation standards.
Effectively maintain open, effective, and collaborative working relationships with internal and external stakeholders.
Assist with work assignment of the auditors and follow up on deliverables to ensure deadlines are met.
Assist with the development and preparation of the annual risk assessment and work plan.
Help evaluate the adequacy and effectiveness of internal and operational controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to corporate integrity and compliance.
Participate in other projects as assigned and complete tasks within requested timeframes. Participate in periodic compliance program effectiveness evaluations.