Healthcare Compliance Auditor — Billing & Coding Expert

Lexington Health; West Columbia (SC); Presencial; USD 80.000 - 110.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Day ONE medical, dental and life

403(b) plan day one match

Employer paid life insurance

Short/long-term disability after 90d

Employee loan forgiveness

Descripción de la vacante

Lexington Health is seeking a qualified auditor to analyze and audit the Physician Network and hospital medical records to ensure charges are supported by documentation and billed correctly. You will monitor risk areas, prepare reports, and present audit results to physicians and APPs.

The role requires a Bachelor’s Degree in Business or a related field and at least 3 years of directly related experience, with CMPA/CCS/CPC certifications encouraged.

Formación

• Bachelor’s Degree in Business or Related Field preferred.
• 3 years of directly related experience required.
• CPMA/CCS/CPC certifications encouraged; CPMA must be obtained within 1 year of entry.

Responsabilidades

• Conduct audits of hospital and Physician Network records to ensure services are documented and billed correctly according to Medicare, Medicaid, and third-party regulations.
• Assist the Chief Compliance Officer in investigations related to erroneous billing and coding.
• Collaborate with Revenue Integrity and Health Information Management on reviews and inquiries.
• Draft formal written reports summarizing medical record findings for review.
• Educate LMC staff on coding and billing changes as needed.
• Verify Medicare/CMS criteria and local guidance are applied in reviews.

Conocimientos

Communication

Problem solving

MS Office

Educación

Bachelor’s Degree in Business or Related Field

High School Diploma with 7 years of related experience

Associate’s Degree with 5 years of related experience

Herramientas

Microsoft Office

Descripción del empleo

Lexington Health is seeking a qualified auditor to analyze and audit the Physician Network and hospital medical records to ensure charges are supported by documentation and billed correctly. You will monitor risk areas, prepare reports, and present audit results to physicians and APPs.

The role requires a Bachelor’s Degree in Business or a related field and at least 3 years of directly related experience, with CMPA/CCS/CPC certifications encouraged.