Compliance Auditing Specialist- Remote/Hybrid available

Westchester Medical Center Health Network; Valhalla (NY); Hybrid; USD 60,000 - 100,000; Full time

Job summary

An established healthcare provider is seeking a Compliance Auditing Specialist to enhance the accuracy of medical coding and documentation. This role involves auditing medical records, managing queries, and providing training to ensure compliance with industry standards. The ideal candidate will have experience in clinical documentation improvement and HCC coding, along with relevant credentials. This position offers the flexibility of remote or hybrid work arrangements, making it an attractive opportunity for professionals looking to make a significant impact in healthcare compliance.

Qualifications

• 3+ years of experience in clinical documentation improvement related to HCC coding.
• Credentials such as CRC, CPC, CPMA, or CCDS are preferred.

Responsibilities

• Audit medical records for compliance with coding standards.
• Manage query processes to address documentation inaccuracies.
• Monitor key performance indicators for clinical documentation.

Skills

HCC Coding

Clinical Documentation Improvement

Data Compilation

Audit Management

Performance Monitoring

Education

Bachelor's Degree in a related field

Tools

Coding Standards

Documentation Software

Job description

Job Title: Compliance Auditing Specialist - Remote/Hybrid Available

Join to apply for the Compliance Auditing Specialist - Remote/Hybrid available role at Westchester Medical Center Health Network.

Job Summary: Serves as an internal expert on Risk Adjustment and Hierarchical Conditions Categories (HCC) coding. Responsibilities include performing concurrent and retrospective reviews of documentation and coding, working with providers and staff to ensure accuracy and completeness of medical record documentation and coding, and providing training, education, and coaching to ensure compliance with standards.

Responsibilities:

1. Audit medical records to ensure compliance with coding and documentation standards.
2. Manage query processes to identify and address inaccurate documentation or coding.
3. Compile data to identify areas for documentation and coding improvement.
4. Monitor and report on key performance indicators related to clinical documentation and HCC coding.
5. Maintain records of audits, queries, and educational efforts; track and report on program effectiveness.
6. Stay current with clinical documentation improvement and coding standards through continuing education.
7. Assist with compliance audits and other duties as needed.
8. Promote appropriate documentation through interaction with physicians, nursing staff, and other caregivers.
9. Serve as a resource for documentation and coding; develop and monitor procedures supporting organizational goals.

Qualifications/Requirements:

• Approximately 3 years of experience in clinical documentation improvement related to HCC coding in the ambulatory setting.
• Credentials such as CRC, CPC, CPMA, or CCDS.
• Bachelor's Degree in a related field.
• Remote/Hybrid work availability.

Additional Details:

• Seniority Level: Mid-Senior level
• Employment Type: Full-time
• Job Function: Finance and Sales
• Industry: Hospitals and Health Care