Lead Compliance Auditor
2 weeks ago
Position: Lead Compliance Auditor
We are seeking a highly skilled Lead Compliance Auditor to join our esteemed healthcare organization.
Key Responsibilities:
- Engage in external regulatory audits, collaborating with agencies such as OMIG, OIG, AG, and OSC.
- Facilitate communication with external bodies concerning audit processes.
- Assist in the formulation of voluntary disclosures and financial repayments to relevant federal and state entities.
- Oversee and execute audits of medical records, ensuring compliance in documentation, coding, and billing for both technical and professional services, including CPT, ICD10, HCPCSII, DRG, APC, APG, Modifiers, Teaching Physician Guidelines, and NPP documentation.
- Prepare comprehensive audit reports detailing findings and recommendations for presentation to senior management, the Executive Compliance Committee, and the Board of Trustees.
- Design and deliver educational programs on documentation, coding, and billing for physicians, allied health professionals, and coding associates on an annual basis.
- Conduct personalized educational sessions based on audit results.
- Manage responses to inquiries related to compliance through various communication channels.
Work Arrangement: This position offers a hybrid work model.
Qualifications:
- Bachelor's degree is preferred.
- A minimum of 3 years of compliance experience in an academic healthcare environment.
- Thorough understanding of local, state, and federal regulations.
- Coding certification (such as CCS, CPC, RHIA, RHIT) or the ability to obtain one within the first year of employment.
- Familiarity with compliance auditing software such as EPIC, SMART, 3M, or MD Audit is advantageous.
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