Compliance Coding Auditor

1 week ago

Norfolk, Virginia, United States Sentara Healthcare Full time

Sentara is hiring a Compliance Coding Auditor-Remote:

  • _-> Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington State, West Virginia, Wyoming_


The Compliance Coding Auditor performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits.


The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines.

Both ICD and CPT coding methodologies are used in the internal audit activity.

The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year.

All queries arising from the audit process are managed by the Compliance Auditor. Follows audit plan, completing numerous audits and providing follow-up to coders, management, and physicians. Looks for new problem areas, trends, etc., and advises Manager of Audit and Coding Compliance. Works with leadership regarding scheduling of internal and external audits.

Required:

Associates degree required or 2 years of related experience in lieu of education, plus 4 years of related experience.

  • Experience must include Ambulatory/Acute Care and Primary Care &/or Specialty Professional Coding. Should have high degree of comfort with technology; possess excellent oral and written communication skills, including basic teaching and presentation skill set; requires a high level of organizational skills, welldeveloped logical thinking and advanced problem solving skills.
  • New Hire Education Requirement: All Registered Nurses who do not have their BSN will be required to sign a BSN Agreement committing to successfully obtain their BSN within 5 years of hire.

Diversity and Inclusion at Sentara
Our vision is that everyone brings the strengths that come with diversity to work with them every day.

When we are achieving our vision, we have team members that feel they belong and can be their authentic selves, and our workforce is reflective of the communities we serve.


We are realizing this vision through our Diversity and Inclusion strategy, which has three pillars: A diverse and talented workforce, an inclusive and supportive workplace, and outreach and engagement with our community.

We have made remarkable strides in these areas over the past several years and, as our world continues to evolve, we know our work is never done.


Our strategies focus on both _structural inclusion_, which looks at our organizational structures, processes, and practices; as well as _behavioral inclusion_, which evaluates our mindsets, skillsets, and relationships.

Together, these strategies are moving our organization forward in an environment that fosters a culture of mutual respect and belonging for all.


Please visit the link below to learn more about Sentara's commitment to diversity and inclusion:

Sentara Overview

For more than a decade, Modern Healthcare magazine has ranked Sentara Health as one of the nation's top integrated healthcare systems.

That's because we are dedicated to growth, innovation, and patient safety at more than 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals.


Sentara Benefits

As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers.

We offer a variety of amenities to our employees, including, but not limited to:

  • Medical, Dental, and Vision Insurance
  • Paid Annual Leave, Sick Leave
  • Flexible Spending Accounts
  • Retirement funds with matching contribution
  • Supplemental insurance policies, including legal, Life Insurance and AD&D among others
  • Work Perks program including discounted movie and theme park tickets among other great deals
  • Opportunities for further advancement within our organization
Join our team We are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, and growth

Please Note:
The yearly Flu Vaccination is required for employment.

  • Sentara Health offers employees comprehensive health care and retirement _
- benefits designed with you in mind. Our benefits packages are designed to change with you by meeting your needs now and anticipating what comes next. You have a variety of options for medica

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