Credentialing and Auditing Specialist

2 days ago

Memphis TN, United States American Esoteric Laboratories Full time

Job Functions, Duties, Responsibilities and Position Qualifications:

The Compliance Audit Specialist reports to the Director of Compliance and will assist with and support the compliance program activities of American Esoteric Laboratories (AEL).

The Compliance Audit Specialist will support the compliance department through auditing/monitoring, planning, education, assessment, and other compliance program functions including any existing compliance activities, with a particular focus on clinical/billing compliance and data analytics.

This opportunity is:

Location: Memphis, Tn 38134

Days: 40 hrs a week

Full Time: Benefit Eligible

In this role, you will:

  • Perform annual compliance department risk assessment to develop annual department work plan  
  • Design data tracking systems to detect, monitor, audit and track data to aid in identifying risk areas and correct non compliances
  • Prepare compliance audit data by compiling and analyzing internal and external data
  • Manage audits of federal and state exclusion sanctions lists for employees, vendors and clients
  • Monitor and assist with annual and new hire compliance and HIPAA training
  • Review and audit revenue billing cycle  functions including but not limited to, ABNs, standing orders, charge master, and denials
  • audit findings, communicate to and recommend corrective strategies to agency
  • Establish and refine, as needed, systems to effectively audit and monitor AEL compliance with rules and regulations applying to laboratory operations.
  • Using established inspection tools to identify non-compliances and prepare written report
  • Provide guidance for corrective action, track completion and monitor success. Participate in employee education

All you need, is:

  • Bachelor’s Degree in chemical, biological or medical technician, healthcare compliance, health sciences, healthcare data science, and healthcare administration.
  • Preferred: Certification in Healthcare Compliance and/or Certification in Medical Coding and Billing
  • Minimum of three years in laboratory training and/or experience in a medical laboratory
  • Good knowledge of laboratory medicine at both the technical and administrative levels
  • Highly developed analytical skills for both qualitative and quantitative data
  • Ability to plan and lead projects following tight deadlines
  • Demonstrates a high-level of attention to detail and accuracy
  • Excellent communication skills - strong verbal and written skills

We’ll give you:

  • Appreciation for your work
  • A feeling of satisfaction that you’ve helped people
  • Opportunity to grow in your profession
  • Free lab services for you and your dependents
  • Work-life balance, including Paid Time Off and Paid Holidays
  • Competitive benefits including medical, dental, and vision insurance
  • Help saving for retirement, with a 401(k) plus a company match
  • A sense of belonging – we’re a community

Scheduled Weekly Hours:

40

Work Shift:

Job Category:

Administration

Company:

We also want you to know:

This role will have routine access to Protected Health Information (PHI). Employees will be trained on reasonable safeguards and are expected to maintain strict confidentiality, as well as abide by all applicable privacy and security standards.  Employees are expected only to access PHI when it is required to fulfill job duties.

Sonic Healthcare USA is an equal opportunity employer that celebrates diversity and is committed to an inclusive workplace for all employees. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, age, national origin, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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