Compliance Auditor

Methodist Healthcare; United States; Remote; USD 50,000 - 80,000; Full time

Job summary

Join a forward-thinking healthcare organization dedicated to making a meaningful impact in the community. This role involves conducting compliance audits, reviewing coding and billing practices, and ensuring adherence to regulatory standards. You will work alongside passionate professionals committed to excellence in patient care. With a strong emphasis on integrity and teamwork, this position offers the opportunity to contribute to the health and well-being of the Memphis community. If you are looking for a fulfilling career where you can make a difference, this is the perfect opportunity for you.

Qualifications

• 3-5 years of experience in coding and compliance auditing.
• Must possess excellent communication and analytical skills.

Responsibilities

• Conduct compliance audits and monitoring as per the audit plan.
• Review coding and billing practices for regulatory compliance.
• Assist with education and training on coding and billing practices.

Skills

Verbal Communication

Written Communication

Interpersonal Skills

Organizational Skills

Analytical Skills

Problem Solving

Knowledge of Medicare and Medicaid

Education

High School Diploma or Equivalent

Associate's Degree in Business Administration/Management

Associate's Degree in Health Information Management

Associate's Degree in Finance

Associate's Degree in Healthcare Administration

Bachelor's Degree in Health Information Management

Bachelor's Degree in Healthcare Administration

Bachelor's Degree in Business Administration/Management

Bachelor's Degree in Finance

Tools

MS Office (Word, Excel, Outlook, PowerPoint)

Job description

If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One!

We strive to be an employer of choice and establish a reputation for being a talent rich organization where Associates can grow their career caring for others. For over a century, we’ve served the health care needs of the people of Memphis and the Mid-South.

Conducts auditing and monitoring as set forth in the annual compliance audit plan including making recommendations of corrective action plan and audit follow-up. Serves as a subject matter expert for a variety of coding and billing related compliance issues. Coordinates, assists and conducts internal investigations related to coding and documentation issues as directed by the Compliance Manager. Models appropriate behavior as exemplified in The Methodist Mission, Vision and Values. Working at MLH means carrying the mission forward of caring for our community and impacting the lives of patients in every way through compassion, a deliberate focus on service expectations and a consistent thriving for excellence.

A Brief Overview

Conducts auditing and monitoring as set forth in the annual compliance audit plan including making recommendations of corrective action plan and audit follow-up. Serves as a subject matter expert for a variety of coding and billing related compliance issues. Coordinates, assists and conducts internal investigations related to coding and documentation issues as directed by the Compliance Manager. Models appropriate behavior as exemplified in The Methodist Mission, Vision and Values.

What you will do

• Performs compliance auditing and monitoring pursuant to the annual compliance audit plan.
• Reviews coding and billing practices to ensure compliance with regulatory requirements. Analyzes findings and makes recommendations for corrective action plans.
• Monitors implementation of corrective action plans and performs audit follow up to verify correction and compliance.
• Assists and makes recommendations to updating annual audit plan.
• Assists with education and training of providers and associates regarding coding and billing practices.

Education/Formal Training Requirements

• High School Diploma or Equivalent
• Associate's Degree Business Administration/Management
• Associate's Degree Health Information Management
• Associate's Degree Finance
• Associate's Degree Healthcare Administration
• Bachelor's Degree Health Information Management
• Bachelor's Degree Healthcare Administration
• Bachelor's Degree Business Administration/Management
• Bachelor's Degree Finance

Work Experience Requirements

• 3-5 years Coding
• 3-5 years Compliance

Licenses and Certifications Requirements

• Certified Coding Specialist - American Health Information Management Association
• Certified Coding Specialist-Physician-based - American Health Information Management Association
• Certified Outpatient Coder (COC) - American Academy of Professional Coders
• Certified Professional Coder - American Academy of Professional Coders
• Registered Health Information Administrator - American Health Information Management Association
• Registered Health Information Technician - American Health Information Management Association

Knowledge, Skills and Abilities

• Knowledge of Medicare and Medicaid documentation and coding rules and guidelines.
• Must have an understanding or develop knowledge of national and state laws and regulations including but not limited to: • False Claims Act • Physician Self-Referral (Stark) Anti-kickback statute • Health Insurance Portability Act (HIPPA) • Health Information Technology for Economic and Clinical Health (HITECH)
• Must have excellent verbal and written communication skills.
• Strong interpersonal skills and evidence of previous success in dealing with staff at all levels, including nurses, non-physician practitioners, physicians, and management.
• Strong organizational and planning skills.
• Demonstrates a high degree of personal integrity and practice ethical standards.
• Demonstrates proactiveness and ability to work independently and self-directed in managing multiple concurrent projects.
• Excellent analytical and problem solving skills.
• Advanced skills in all MS Office applications (Word, Excel, Outlook, and PowerPoint).
• Ability to interpret and apply documentation and coding rules and regulations.
• Ability to demonstrate competence in performing audits, produce reports, formulate remediation or mitigation plans, and conduct follow-up audits.

Supervision Provided by this Position

• There are no supervisory or lead responsibilities assigned to this job.

Physical Demands

• The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
• Must have good balance and coordination.
• The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
• The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
• The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work.

Our Associates are passionate about what they do, the service they provide and the patients they serve. We value family, team and a Power of One culture that requires commitment to the highest standards of care and unity.

Education:
Associates Degree: Business Administration/Management (Required), Associates Degree: Finance (Required), Associates Degree: Healthcare Administration (Required), Associates Degree: Health Information Management (Required), Bachelor's Degree: Business Administration/Management, Bachelor's Degree: Finance, Bachelor's Degree: Healthcare Administration, Bachelor's Degree: Health Information Management, High School Diploma or Equivalent

Work Experience:
Coding, Compliance

Certifications:
Certified Coding Specialist - American Health Information Management Association, Certified Coding Specialist-Physician-based - American Health Information Management Association, Certified Outpatient Coder (COC) - American Academy of Professional Coders, Certified Professional Coder - American Academy of Professional Coders, Registered Health Information Administrator - American Health Information Management Association, Registered Health Information Technician - American Health Information Management Association

Boasting one of the South's largest medical centers, Memphis blends a friendly community, a thriving and growing downtown, and a low cost of living. We see each day as a new opportunity to make a difference in the lives of the people in our community.