Medical Group Compliance Auditor Senior

7 days ago

Greensboro, NC, United States Cone Health Full time

The Medical Group Compliance Auditor Senior is responsible for providing audit, coding support and guidance to physicians, APPs, residents and support staff. This role ensures that all coding, billing and documentation complies with federal and/or state regulations, private payer health care program requirements as well as the Compliance and Operations Policies of the organization. This job assists with the development and implementation of educational and training programs as well as coding tools and resources to help achieve organization?s goal of consistent, complete and accurate coding and documentation.

Essential Job Function

  • Capable of working independently to conduct regularly scheduled compliance reviews for assigned providers, practices, and focused review areas within designated time frames.
  • Provides mentorship and guidance to the more junior Medical Group Compliance Auditor during the audit completion process.
  • Performs Reviews clinical documentation to verify accuracy of CPT/HCPSC and ICD.
  • 10 codes and modifier assignments.
  • Provides written report of findings to the provider and select administrative personnel along with recommendations for improvement.
  • Monitors regulatory and reimbursement information to keep informed of relevant changes and updates.
  • Performs special demand audits as requested or noted in compliance or audit work plans program.
  • Educates providers one-on-one or in a group setting based on need or as a result of an audit.
  • Provides oversight and quality assessment of audit and other work of Medical Group Compliance Auditors as well as peers.
  • Maintains effective communication with department staff as well as key stakeholders and consistently demonstrates high standards of professional conduct and ethics, as well as appropriate judgment, independence, and discretion.
  • Performs other duties as assigned.

Education
  • Required: Bachelor's Degree, required; or Associates Degree, required with 5 years of auditing experience.

Experience
  • Required: 5 years of professional coding experience with a minimum of two years auditing experience for coding compliance/accuracy, with Bachelor's Degree,

Licensure/Certification/Listing
  • Required: One of the following: Certified Professional Coder (CPC) or Certified Coding Specialist (Physician-based) (CCS-P). Preferred: Any additional certifications such as Evaluation and Management Coder (CEMC) or Certified Professional Medical Auditor (CPMA).

  • Financial Compliance Business Partner

    2 weeks ago

    Greensboro, NC, United States Syngenta Group Full time

    Company Description As a world market leader in crop protection, we help farmers to counter these threats and ensure enough safe, nutritious, affordable food for all -while minimizing the use of land and other agricultural inputs. Syngenta Crop Protection keeps plants safe from planting to harvesting. From the moment a seed is planted through to harvest,...

  • Financial Compliance Business Partner

    1 week ago

    Greensboro, NC, United States Syngenta Group Full time

    Company Description As a world market leader in crop protection, we help farmers to counter these threats and ensure enough safe, nutritious, affordable food for all -while minimizing the use of land and other agricultural inputs. Syngenta Crop Protection keeps plants safe from planting to harvesting. From the moment a seed is planted through to harvest,...

  • Financial Compliance Business Partner

    5 days ago

    Greensboro, NC, United States Syngenta Group Full time

    Company Description As a world market leader in crop protection, we help farmers to counter these threats and ensure enough safe, nutritious, affordable food for all -while minimizing the use of land and other agricultural inputs. Syngenta Crop Protection keeps plants safe from planting to harvesting. From the moment a seed is planted through to harvest,...

  • Financial Compliance Business Partner

    3 days ago

    Greensboro, NC, United States Syngenta Group Full time

    Company Description As a world market leader in crop protection, we help farmers to counter these threats and ensure enough safe, nutritious, affordable food for all -while minimizing the use of land and other agricultural inputs. Syngenta Crop Protection keeps plants safe from planting to harvesting. From the moment a seed is planted through to harvest,...

  • Auditor II

    23 hours ago

    Greensboro, NC, United States North Carolina Agriculture & Technical State Unive Full time

    Description: The primary purpose of this position is to conduct operational, compliance, financial, and special audits or consultations with the objective of providing assurance that: Internal controls are adequate and effective; Operations promote efficiency and compliance with policies, applicable laws and regulations; and; Assets of the University...

  • Auditor II

    1 day ago

    Greensboro, NC, United States North Carolina A&T State University Full time

    Posting Details Classification Information Classification Type EHRA Position Overview Primary Purpose of Position The primary purpose of this position is to conduct operational, compliance, financial, and special audits or consultations with the objective of providing assurance that: 1) Internal controls are adequate and effective; 2) Operations promote...

  • Internal Auditor

    2 weeks ago

    Greensboro, NC, United States Advanced Personnel Resources Full time

    INTERNAL AUDITOR Our client, a global manufacturer and industry leader, has an immediate need for an Internal Auditor at its Corporate Headquarters in central North Carolina. This is an excellent career growth position with advancement opportunities after a couple of years! Under general supervision, the Internal Auditor is responsible for organizing,...

  • Internal Auditor

    2 weeks ago

    Greensboro, NC, United States Advanced Personnel Resources Full time

    INTERNAL AUDITOR Our client, a global manufacturer and industry leader, has an immediate need for an Internal Auditor at its Corporate Headquarters in central North Carolina. This is an excellent career growth position with advancement opportunities after a couple of years! Under general supervision, the Internal Auditor is responsible for organizing,...

  • Internal Auditor

    1 week ago

    Greensboro, NC, United States Advanced Personnel Resources Full time

    INTERNAL AUDITOR Our client, a global manufacturer and industry leader, has an immediate need for an Internal Auditor at its Corporate Headquarters in central North Carolina. This is an excellent career growth position with advancement opportunities after a couple of years! Under general supervision, the Internal Auditor is responsible for organizing,...

  • Senior Manufacturing Accountant

    2 weeks ago

    Greensboro, NC, United States Advanced Personnel Resources Full time

    Senior Manufacturing Accountant Our client, a leader in the manufacture of quality contract, healthcare, educational and governmental furniture for over 60 years is seeking a Senior Accountant. This is a great opportunity for a senior accountant to work for a small but growing furniture manufacturer. Duties Include: Maintain the general ledger...