Remote Senior Coding Compliance Auditor

Ensemble Health Partners; United States; Remote; USD 76,000 - 132,000; Full time

Benefits offered by this job

Bonus Incentives

Paid Certifications

Tuition Reimbursement

Comprehensive Benefits

Career Advancement

Job summary

Ensemble Health Partners is seeking a Senior Coding Compliance Auditor to lead annual compliance workplans and conduct detailed coding audits across acute care, maximizing accuracy and regulatory alignment, working with service line leaders to develop MAPs.

The role requires 5-7+ years in healthcare coding, auditing and compliance, with knowledge of ICD-10, DRG, CPT, and various EMR systems. This remote position offers travel up to 10% and opportunities for professional growth.

Qualifications

• 5-7+ years of experience in healthcare, acute coding, Compliance, audits, or related field
• ICD-10, DRG, CPT & HCPCS coding knowledge to include Acute Outpatient and Inpatient experience
• Revenue cycle operations, Compliance standards, auditing standards knowledge
• Epic, Cerner, and/or Meditech knowledge
• Basic Word & Excel knowledge
• Long-distance or air travel - not to exceed 10% travel
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences
• This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require

Responsibilities

• Conduct detailed coding auditing and monitoring activities on acute side.
• Analyze audit findings to identify discrepancies, trends, patterns which may lead to potential non-compliance and develop well thought actionable recommendations to mitigate associated risks, and partner with the service line leaders to develop and validate Management Action Plans.
• Create and maintain an Audit the Auditor program to monitor quality and identify opportunities for improvement related to audit management tools as well as audit processes.
• Provide regular updates to the Compliance leader on audits, MAPs outcomes, and elevate potential compliance concerns which require immediate attention.
• Create and maintain training material for Audit process and how to use the Audit Management tool/platform. And leverage it to provide training, education, and ongoing support to the auditors.
• Effectively and timely communicate coding compliance concerns to Compliance leadership through identifying trends and patterns.
• Serve as a resource for Coding leaders on compliance audits related questions and concerns. Keep up with coding guidelines and industry standards for coding practices.
• Create and maintain Compliance audit records, analytical reports, and track and trend compliance audit program activities; manage compliance audit program issue logs and dashboards.
• Maintains accurate, complete, and up-to-date compliance documents and records and produce for Compliance leadership upon request.
• Assist with onboarding of the new Compliance coding auditors and serve as a resource for the auditors to address their questions/concerns.
• Foster a culture of compliance and continuous improvement within the department and the organization.
• Assist with assessing the Compliance audit program on ongoing basis to identify opportunities for process improvement. Contribute to the achievement of Compliance Department goals and objectives and adhere to departmental policies, procedures, and standards; comply with organizational policies and procedures, governmental laws and regulations and accreditation standards.
• Effectively maintain open, effective, and collaborative working relationships with internal and external stakeholders.
• Assist with work assignment of the auditors and follow up on deliverables to ensure deadlines are met.
• Assist with the development and preparation of the annual risk assessment and work plan.
• Help evaluate the adequacy and effectiveness of internal and operational controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to corporate integrity and compliance.
• Participate in other projects as assigned and complete tasks within requested timeframes. Participate in periodic compliance program effectiveness evaluations.
• This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Associates may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Skills

Healthcare coding

ICD-10/DRG/CPT

Compliance knowledge

EMR Systems

MS Office

Travel willing

AI innovation

Independent work

Education

Bachelor's degree or equivalent experience in Health Records Management/Medical Coding

Job description

Ensemble Health Partners is seeking a Senior Coding Compliance Auditor to lead annual compliance workplans and conduct detailed coding audits across acute care, maximizing accuracy and regulatory alignment, working with service line leaders to develop MAPs.

The role requires 5-7+ years in healthcare coding, auditing and compliance, with knowledge of ICD-10, DRG, CPT, and various EMR systems. This remote position offers travel up to 10% and opportunities for professional growth.