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Hospital Compliance Auditor
1 month ago
We are seeking an experienced Hospital Compliance Auditor to join our team at Emory Healthcare. As a Hospital Compliance Auditor, you will play a key role in ensuring the accuracy and compliance of our inpatient hospital coding and billing practices.
In this position, you will lead audits and reviews to investigate adherence with inpatient hospital/clinical billing compliance policies, legal and regulatory requirements, and to identify and evaluate risk areas. You will also assist in the development of organizational compliance auditing and monitoring activities for hospital/clinical billing and coding.
You will work closely with internal coders and managers, 3rd party clinical reviewers, and senior leaders to ensure that training is current, relevant, and innovative. You will evaluate training methods and modalities and implement new approaches as needed. You will also provide counseling, education, and recommended disciplinary action if necessary or required for non-compliance with any internal or external policies and procedures related to hospital/clinical billing compliance.
The ideal candidate will have a Bachelor's degree and a minimum of three years of experience with either inpatient or outpatient audit activities. You will be proficient in MDAudit Enterprise software and Epic electronic health record systems. A thorough knowledge of coding documentation improvement practices is required.
As a Hospital Compliance Auditor, you will have a strong understanding of hospital inpatient billing, coding, and documentation requirements, Federal and State regulations, medical necessity, clinical best practices, and hospital/clinical billing issues. You will also possess excellent communication and interpersonal skills, with the ability to clearly communicate coding information and results of coding compliance audit activities.
