Integrity Auditor

3 weeks ago


San Antonio TX, United States University Health Full time

POSITION SUMMARY/RESPONSIBILITIES
Works to utilize the department’s resources for analytical auditing and monitoring activities related to University Health’s compliance program
Additionally, the position is responsible for assisting with the development and execution of the Compliance Work Plan under the supervision of the Chief Compliance/HIPAA Officer
Conducts complex operational and compliance audits from inception to completion in accordance with departmental practices and procedures
Primarily, the scope of audits and reviews will be in the areas of coding, billing, medical record documentation, claims, clinical data, and reports as they relate to the revenue cycle
Will routinely review and evaluate University Health’s internal control structures within revenue cycle activities to ensure they adequately prevent and detect errors, fraud, waste and abuse
Assists with other audits and investigations with approval from the Chief Compliance/HIPAA Officer
Performs duties and assignments promptly and efficiently
Strives to protect the department’s reputation for creditability and objectivity
Maintains good public/working relations with other University Health executives, members of the Board of Managers, co-workers, employees, doctors, patients and guests
Handles all personal contacts with professionalism, efficiency and integrity while preserving the confidential nature of information.

EDUCATION/EXPERIENCE
Bachelor’s degree from an accredited college or university strongly preferred
Certification from AAPC or AHIMA as a Certified Professional Coder (CPC) and Certified Professional Medical Record Auditor (CMPA), Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), or a Registered Health Information Technician (RHIT) is required
Minimum three years’ experience performing various claims validation reviews in a multi-specialty outpatient/Ambulatory Surgery Center is strongly preferred
Expert knowledge of ICD, CPT, HCPCS coding classifications required and DRG, APC and ASC payment methodology preferred.


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