E&M Compliance Auditor

Ochsner Health; United States; On-site; USD 50,000 - 80,000; Full time

Job summary

Join a forward-thinking healthcare organization dedicated to making a difference in patient care. This role focuses on maintaining a robust auditing and compliance program, ensuring that all projects and services align with the department's goals. You will have the opportunity to independently manage audits, educate staff on compliance matters, and contribute to the overall effectiveness of the organization. If you are passionate about healthcare and compliance, this position offers a chance to make a significant impact while working in a supportive environment.

Qualifications

• 3+ years of experience in healthcare audit, billing, compliance, or coding.
• Certification as CPC, CCS, CHC, RHIA, RHIT, RN, or LPN required.

Responsibilities

• Conducts audits and compliance projects independently.
• Educates employees on compliance and coding/billing issues.
• Reports findings to management and assists in compliance efforts.

Skills

Verbal Communication

Written Communication

Organizational Skills

Self-Directed Work

Integrity

Education

High School Diploma or Equivalent

Bachelor's Degree in Health Information Management, Accounting, Finance, or Related Field

Tools

Computer Software

Web-Based Applications

Job description

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.

At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!

This job assists with maintaining an effective auditing and compliance program. Independently completes assignments, manages projects, performs audits, and ensures assignment objectives are achieved. Ensures that projects, coverage, and services are completed as defined for areas of responsibility in the department’s annual plan and meet the needs of the Audit and Oversight Committee of the Board of Directors and executive management. Performs and documents audits and presents oral and written conclusions to the Lead Nurse Auditor and department management. Educates and assists employees in applying and improving overall compliance.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

Education

Required - High school diploma or equivalent.

Preferred - Bachelor's degree in health information management, accounting, finance, or related healthcare field.

Work Experience

Required - 3 years of experience in healthcare audit, billing, compliance, or specialized coding.

Certification

Required - Certification as CPC, CCS, CHC, RHIA, RHIT, RN, or LPN or other related certification.

Knowledge Skills and Abilities (KSAs)

• Proficiency in using computers, software, and web-based applications.
• Effective verbal and written communication skills and ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
• Strong organizational skills.
• Ability to work self-directed, under minimal supervision.
• Ability to work with high integrity.
• Ability to travel throughout and between facilities.

Job Duties

• Independently works on coding/billing compliance related projects, audits, and investigations.
• Reports on coding/billing and compliance issues detected through auditing and monitoring or other means to the Lead Nurse Auditor and/or designated departmental leadership.
• Ensures that all audits, performance, documentation, follow-up, and organization are conducted in compliance with department and organizational standards.
• Completes projects and assignments by or before the agreed-upon target date set by the auditor and approved by the Lead Nurse Auditor and/or designated departmental leadership.
• Assists management and providers in compliance efforts and provides basic training for employees.
• Provides employees with in-services and other educational services, in regards to risks and compliance-related matters within area(s) of expertise, as requested by the Lead Nurse Auditor and/or designated departmental leadership.
• Performs other related duties as required.

The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.

Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.

This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns.

The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.

Physical and Environmental Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects. (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible.

Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid.

The incumbent has no occupational risk for exposure to communicable diseases.

Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.

Are you ready to make a difference? Apply Today!

Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website.

Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Hawaii, Illinois, Maryland, Minnesota, New York, Washington, and Washington D.C.

Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at 504-842-4748 (select option 1) or [e-mail]. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.

Ochsner is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to any legally protected class, including protected veterans and individuals with disabilities.