Provider Coding Compliance Auditor

Baylor Scott & White Health; Carson City (NV); On-site; USD 63,000 - 95,000; Full time

Job summary

BSWH is seeking a Provider Coding Compliance Consultant who reports to the Coding Compliance Manager. This role develops, implements, and maintains BSWH policies to ensure adherence to laws and regulations. The candidate will perform activities across audits, education, and compliance initiatives.

The position involves identifying audit projects, conducting audits of provider services, and delivering reports with risk assessments. Strong communication and CPT/ICD-10-CM knowledge are essential.

Qualifications

• Bachelor’s in HIM or 4 years of physician/professional coding experience.
• Certifications CPC, CCS, or CCS-P preferred or required.

Responsibilities

• Identifies appropriate projects for audits and schedules audits with appropriate personnel.
• Conducts auditing of provider services, monitoring, and investigating activities to ensure compliance with BSWH policies and laws.
• Provides written audit and investigation reports with risk analysis and improvement steps.
• Obtains corrective action plans for deficiencies and ensures effective implementation.
• Tracks audit findings and surveys audited personnel for satisfaction and effectiveness.
• Provides coding education with providers regarding audit trends and training.
• Serves as a coding compliance resource to BSWH departments on compliance matters.

Skills

Written communication

Verbal communication

Critical thinking

Attention to detail

Integrity

Initiative

Professional growth

Education

Bachelor's in HIM or 4 years of coding experience

CPC/CCS/CCS-P certifications

Tools

Microsoft Word

Microsoft Excel

Job description

BSWH is seeking a Provider Coding Compliance Consultant who reports to the Coding Compliance Manager. This role develops, implements, and maintains BSWH policies to ensure adherence to laws and regulations. The candidate will perform activities across audits, education, and compliance initiatives.

The position involves identifying audit projects, conducting audits of provider services, and delivering reports with risk assessments. Strong communication and CPT/ICD-10-CM knowledge are essential.