Compliance Auditor

C002 Medical University Hospital Authority (MUHA); United States; On-site; USD 65,000 - 90,000; Full time

Job summary

Medical University of South Carolina is seeking a Compliance Auditor to evaluate adherence to laws, regulations, and internal policies through records review, data analysis, and staff interviews. You will support risk assessment, pre/post audit activities, and provide actionable corrective actions.

The role requires a related bachelor's degree (or GED with experience) and credentialing in coding or a similar field.

Qualifications

• Bachelor's degree in a related field and a minimum of 2 years of medical billing, coding, and/or audit experience; college degree preferred.
• Credentialed as a coder or similar professional body (RN, RHIA, CPC) that lends to compliance auditing.
• Effective oral and written communication skills required.

Responsibilities

• Perform audits to evaluate adherence to laws, regulations and policies by reviewing records, analyzing data, and interviewing staff and stakeholders.
• Audit scope includes regulatory research, pre/post audit meetings, cohesive audit reports with corrective action plans, and education to stakeholders.
• Identify high-risk areas via annual risk assessment, and respond to ad hoc audit requests and billing concerns.

Skills

Medical billing

Coding

Audit experience

Education

Bachelor's degree in related field

High school diploma or GED

Job description

Job Description Summary

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.

Entity Medical University Hospital Authority (MUHA) Worker Type Employee Worker Sub-Type Regular Cost Center CC002278 SYS - Compliance Program Pay Rate Type Salary Pay Grade Health-29 Scheduled Weekly Hours 40 Work Shift

Job Description 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.

The audit scope includes:

• 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 or High 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.

Additional Job Description 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)*

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

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.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees

Thank you for wanting to be part of the Medical University of South Carolina team. Whether you want to teach the next generation of health care leaders, innovate new business models, discover the next breakthrough or provide patient care, there's a role for you that fuels your passion and takes advantage of your skills.

There are career opportunities available in academics, research, hospital medicine, physician practices and support services, from patient billing to IT. As an applicant, you can search jobs for all MUSC entities as well as search by category and location.

MUSC attracts more than $250 million annually in research funding, making it the biggest magnet for biomedical, extramural research dollars of all institutions of higher learning in South Carolina.

The Clinical and Translational Science Award (CTSA) Program aims to advance clinical and translational science to increase the speed at which new treatments become available to patients.

MUSC Health, the clinical enterprise, operates a 750 bed medical center, which includes a nationally recognized Children’s Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), Hollings Cancer Center (one of fewer than 70 elite National Cancer Institute designated centers), a Level I Trauma Center and the Institute of Psychiatry. In addition, there are more than 100 outreach clinics, hospital/health system affiliations, and telehealth sites. U.S. News & World Report placed us among the top one percent of all American hospitals, with 11 specialties in the top 50. The MUSC Medical Center is also one of only three Magnet® designated hospitals in South Carolina.