Provider Coding Compliance Auditor & Educator

Baylor Scott & White Health; Augusta (ME); On-site; USD 63,000 - 95,000; Full time

Job summary

Baylor Scott & White Health is seeking a Provider Coding Compliance Consultant to develop, implement, and maintain policies ensuring compliance with federal, state, and local laws. The role reports to the Coding Compliance Manager and collaborates with Compliance leadership.

The position focuses on audits, reporting, corrective action plans, and education for providers across BSWH, with emphasis on CPT/ICD-10-CM and CMS regulations. A NICHE for orthopedics and multiple specialties is noted.

Qualifications

• Strong written and verbal communication with ability to educate providers and present audit findings.
• Attention to detail and integrity in auditing activities.
• Demonstrates initiative and commitment to continuing education and certifications.

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, identifying risks and recommending steps to improve effectiveness.
• Obtains corrective action plans for identified deficiencies and ensures implementation.
• Tracks audit findings and surveys personnel audited for satisfaction and effectiveness.
• Provides and coordinates coding education with providers regarding audit trends and training for compliance initiatives.
• Serves as a coding compliance resource to BSWH departments and entities on basic compliance matters.

Skills

Strong communication

Attention to detail

Critical thinking

Problem solving

Initiative to learn

HCCA Certification Preferred

Advanced knowledge of CPT/ICD-10-CM/HC

Auditing experience in medical billing

Education

Bachelor's in HIM

4 years physician/professional fee coding experience

Medical coding certifications CPC/CCS/CCS-P

Tools

Microsoft Word

Microsoft Excel

Job description

Baylor Scott & White Health is seeking a Provider Coding Compliance Consultant to develop, implement, and maintain policies ensuring compliance with federal, state, and local laws. The role reports to the Coding Compliance Manager and collaborates with Compliance leadership.

The position focuses on audits, reporting, corrective action plans, and education for providers across BSWH, with emphasis on CPT/ICD-10-CM and CMS regulations. A NICHE for orthopedics and multiple specialties is noted.