Provider Compliance Auditor and Educator

1 week ago


Morgantown, West Virginia, United States WVU Medicine Full time

Position Overview:
We are seeking a dedicated individual to fulfill the role of Enterprise Compliance Auditor/Educator. This position is essential in supporting the ongoing compliance auditing, monitoring, and educational initiatives related to all provider services.

Key Responsibilities:
The Enterprise Compliance Auditor/Educator will be responsible for:

  • Conducting thorough compliance audits and reviews, ensuring adherence to CMS regulations and other relevant guidelines.
  • Collaborating with various departments to evaluate audit scopes and develop comprehensive data reports.
  • Researching and interpreting regulatory requirements pertinent to audits.
  • Reviewing medical records and billing documentation to ensure compliance.
  • Preparing detailed audit reports that outline findings and recommendations for corrective actions.
  • Facilitating meetings with departments to discuss audit outcomes and develop necessary action plans.
  • Planning and delivering educational presentations to enhance compliance knowledge across the organization.
  • Coordinating training activities to meet the compliance education needs of staff.
  • Assisting in the development of policies and procedures in response to new regulations.
  • Monitoring compliance with policies and regulatory requirements through ongoing audits and investigations.
  • Compiling compliance statistics and preparing reports for management review.

Qualifications:
Applicants should possess a High School Diploma or equivalent with extensive experience in multi-specialty coding and compliance, or an Associate's Degree with relevant experience. Professional certifications such as CPC, RHIT, or CCS-P are preferred.

Skills Required:
Successful candidates will demonstrate strong analytical skills, effective communication abilities, and proficiency in healthcare compliance and auditing techniques. Organizational skills and the ability to work independently are essential.

Work Environment:
This position will primarily be office-based, requiring extended periods of sitting and computer usage.

WVU Medicine is an Equal Opportunity Employer:
We value diversity and encourage applications from all qualified individuals.



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