Compliance Auditor

Medical University of South Carolina; South Carolina; On-site; USD 60,000 - 90,000; Full time

Job summary

The Medical University of South Carolina is seeking a Compliance Auditor who reports to the Regulatory Audit Manager and conducts audits to evaluate adherence to laws, regulations and policies by reviewing records, analyzing data and interviewing staff.

Duties include planning audits for high-risk areas, holding pre- and post-audit meetings, producing a cohesive report with corrective actions, and educating stakeholders as needed.

Qualifications

• Bachelor's degree in a related field; 2 years of medical billing, coding, or audit experience OR GED with 4 years of medical billing, coding, or audit experience; college degree preferred.
• Professional credential as a coder (RN, RHIA, CPC, etc.) required or helpful.
• Effective oral and written communication skills required.

Responsibilities

• Plan regulatory audits and research high-risk areas per risk assessment.
• Review records, analyze data, and interview staff and stakeholders during audits.
• Prepare cohesive audit reports with corrective action plans when needed.
• Provide education and training to stakeholders as required.

Skills

Communication skills

Education

Bachelor's degree in related field

High school diploma or GED

Credentialed coder (RN/RHIA/CPC)

Job description

Compliance Auditor

The Compliance Auditor reports to the Regulatory Audit Manager and performs audits to evaluate adherence to laws, regulations and policies by reviewing records, analyzing data, and interviewing staff and stakeholders.

Position Purpose:

The Compliance Auditor reports to the Regulatory Audit Manager and performs audits to evaluate adherence to laws, regulations and policies by reviewing records, analyzing data, and interviewing staff and stakeholders. These audits include but are not limited to services identified as high-risk via the annual risk assessment, OIG-CMS-PGBA workplan areas, ad hoc audit requests, and "for cause" coding and billing concerns.

• a) The regulatory and industry research needed for audit planning
• b) Pre and post audit meetings with stakeholders
• c) Cohesive audit report that communicates results and includes a corrective action plan if warranted, and
• d) Education and training to stakeholders as needed

Requirements (Education, Work Experience, Licensure, Registry &/or Certifications):

Bachelor's degree in a related field and a minimum of 2 years of medical billing, coding, and or audit experience orHigh school diploma or equivalent (GED) and 4 years of medical billing, coding, and or audit experience required; college degree preferred. Applicant must be credentialed as a coder or similar professional body (RN, RHIA, CPC, etc.) that lends to compliance auditing. Effective oral and written communication skills required.

Physical Requirements:

• Ability to perform job functions while standing. (Frequent)
• Ability to perform job functions while sitting. (Frequent)
• Ability to perform job functions while walking. (Frequent)
• Ability to climb stairs. (Infrequent)
• Ability to work indoors. (Continuous)
• Ability to work from elevated areas. (Frequent)
• Ability to work in confined/cramped spaces. (Infrequent)
• Ability to perform job functions from kneeling positions. (Infrequent)
• Ability to bend at the waist. (Frequent)
• Ability to squat and perform job functions. (Infrequent)
• Ability to perform repetitive motions with hands/wrists/elbows and shoulders. (Frequent)
• Ability to reach in all directions. (Frequent)
• Possess good finger dexterity. (Continuous)
• Ability to fully use both legs. (Continuous)
• Ability to fully use both hands/arms. (Continuous)
• Ability to lift and carry 15 lbs. unassisted. (Infrequent)
• Ability to lift/lower objects 15 lbs. from/to floor from/to 36 inches unassisted. (Infrequent)
• Ability to lift from 36 inches to overhead 15 lbs. (Infrequent)
• Ability to maintain 20/40 vision, corrected, in one eye or with both eyes. (Continuous)
• Ability to see and recognize objects close at hand or at a distance. (Continuous)
• Ability to match or discriminate between colors. (Continuous)
• * (Selected Positions)Ability to determine distance/relationship between objects; depth perception. (Continuous)
• Ability to maintain hearing acuity, with correction. (Continuous)
• Ability to perform gross motor functions with frequent fine motor movements. (Continuous)
• Ability to work in a latex safe environment. (Continuous)*
• Ability to maintain tactile sensory functions. (Frequent)
• * (Selected Positions) Ability to maintain good olfactory sensory function. (Frequent)
• * (Selected Positions) Ability to be qualified physically for respirator use, initially and as required. (Continuous) (Selected Positions)*

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.