Regulatory Compliance Auditor

2 weeks ago


Nashville, Tennessee, United States VMG Health Full time

Position Overview:
VMG Health is in search of a Compliance Auditor to conduct comprehensive reviews of documentation and coding related to professional services, project management, and report generation for our Coding and Compliance Operational Excellence Team (CCOE).

Role Responsibilities:
The Compliance Auditor will be responsible for providing both internal education to the audit team in specialized practice areas and external training to healthcare providers.

The current audit team comprises a Managing Director, Director, Manager, Supervisor, Auditors, Coders, and Coordinators dedicated to serving healthcare organizations, legal firms, and private equity entities. Our services encompass medical coding, auditing, due diligence coding evaluations, educational initiatives, compliance oversight, and research.

This role presents an exceptional opportunity for a dedicated professional eager to advance their career in medical coding and compliance, supported by a top-tier team.

Key Duties:
- Collaborate with the audit team to deliver client projects that meet productivity benchmarks and deadlines.
- Access and review necessary medical record documentation from clients' electronic medical record systems.
- Conduct thorough analyses of medical records to ensure compliance with chart content and documentation standards.
- Assign diagnostic codes and abstract patient medical record information in accordance with ICD-10-CM and CPT-4 Manuals and established coding guidelines.
- Utilize audit reporting tools to document audit findings and generate reports for quality assurance and client submission.
- Develop comprehensive reports detailing audit results and corrective action plans.
- Facilitate educational sessions for external clients.
- Serve as a resource for providers on coding, documentation, and compliance issues.
- Assist in defining project scope and objectives, ensuring technical feasibility with all relevant stakeholders.
- Review quality assurance of audit reports prepared by team management and implement necessary corrections.
- Stay updated on changes in government regulatory coding and compliance guidelines and third-party payer requirements.
- Maintain knowledge of evolving coding auditing principles and practices to ensure professional competence.

Qualifications:
Education: High school diploma or GED required.
Experience: Minimum of 3 years in CPT and ICD-10 medical coding and auditing, including experience in abstracting information from patient charts.
Licenses/Certifications:
- Coding Credentials: AHIMA – Certified Coding Specialist-Physician (CCS-P) or AAPC – CPC required. CPMA Certification required.
- Preferred: AACP – CPC-I Certified Professional Coding Instructor or CHCA Certification from AHCAE.

Skills:
- Proficiency in Microsoft Office Suite (Outlook, Word, Excel, PowerPoint) and relevant technologies.
- Prior experience in a consulting environment is preferred.
- Experience in providing one-on-one and group education and training to providers.
- Proven ability to work independently with high productivity levels.
- Strong time management skills, with the ability to prioritize and manage multiple tasks in a fast-paced environment.
- Excellent attention to detail and communication skills, both in individual and group settings.
- Strong organizational, planning, problem-solving, and decision-making abilities, with a focus on quality management and results orientation.



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