Healthcare Compliance Auditor: Medicare & Coding Expert

Lexington Health; Columbia (SC); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Life insurance

Disability coverage

403(b) match

Tuition reimbursement

Student loan forgiveness

Job summary

Lexington Health in Columbia, SC is seeking a Corporate Compliance Analyst to analyze and audit LMC systems and the hospital medical record data to ensure charges billed are supported by documentation. You will monitor risk areas and conduct focused audits, preparing reports and meeting with physicians and APPs to review results.

You will collaborate with Health Information Management and Revenue Integrity, draft formal reports, and educate staff on coding and billing changes while ensuring

Qualifications

• Bachelor’s degree in Business or related field required.
• 3 years of directly related experience.
• CPC or CCS certification required.
• CPMA certification must be obtained within 1 year.
• Strong problem solving and communication skills; articulate complex issues.
• Proficient in Microsoft Office.

Responsibilities

• Audit hospital and Physician Network records for proper documentation and billing.
• Assist Chief Compliance Officer on investigations related to billing and coding.
• Coordinate with Revenue Integrity for coding reviews.
• Draft formal reports summarizing findings.
• Educate staff on reviews and coding changes.
• Ensure compliance with CMS/NCDs, LCDs and related guidance.

Skills

Problem solving

Communication

Microsoft Office

Education

Bachelor’s Degree in Business or Related Field

Tools

Microsoft Office

Job description

Lexington Health in Columbia, SC is seeking a Corporate Compliance Analyst to analyze and audit LMC systems and the hospital medical record data to ensure charges billed are supported by documentation. You will monitor risk areas and conduct focused audits, preparing reports and meeting with physicians and APPs to review results.

You will collaborate with Health Information Management and Revenue Integrity, draft formal reports, and educate staff on coding and billing changes while ensuring