Sr. Compliance Auditor Trainer

The Johns Hopkins University; Baltimore (MD); Hybrid; USD 73,000 - 129,000; Full time

Job summary

An established industry player is seeking a Sr. Compliance Auditor Trainer to enhance the quality of medical record documentation and billing compliance. This role involves conducting audits, providing targeted training, and collaborating with various departments to ensure adherence to compliance standards. The ideal candidate will have a strong background in auditing and billing compliance, coupled with excellent training skills. Join a dynamic team dedicated to improving healthcare practices and ensuring compliance with regulations. This is a fantastic opportunity to make a significant impact in a supportive and innovative environment.

Qualifications

• 4+ years of auditing/billing compliance experience required.
• Professional coding certification required by start date.

Responsibilities

• Conducts audits on medical record documentation adequacy.
• Provides training sessions for providers and billing staff.
• Analyzes documentation patterns and recommends solutions.

Skills

Auditing

Billing Compliance

Training and Teaching

Documentation Analysis

Problem Solving

Education

Bachelor’s Degree in health care-related or business-related field

Tools

Epic Billing

Meditech

EPR

Eclypsis

IDX

Job description

We are seeking a Sr. Compliance Auditor Trainer who will provide ongoing training and support to physicians, non-physician providers, professional fee billing staff, clinic staff, administrators, and other affected personnel on documentation and billing requirements. Using auditing and analysis techniques, determines the adequacy of medical records documentation, coding and billing for all providers across all clinical specialties. Works in close collaboration with the clinical departments, Physicians Billing Service, and the Johns Hopkins Health System Compliance Office. The documentation audits are conducted as part of the School of Medicine’s Quality Assurance Compliance Program. Prepares reports for the Senior Director, Director, and clinical departments regarding the status or results of the reviews. Summary results are presented to the Clinical Practice Association’s Board of Governors, the University’s Trustee Committee for Audits and Insurance and other appropriate offices within the School of Medicine or Johns Hopkins Medicine.

Specific Duties & Responsibilities

• Conducts independent reviews/audits on the adequacy of medical record documentation to support the codes selected by providers or by billing office coders.
• Verifies and corrects as necessary, the audit work completed by the Compliance Auditors or other Sr. Auditors/Trainers.
• Analyzes documentation or coding patterns by a provider, division or department that poses a compliance risk and recommends solutions to address the problem(s).
• Assists departments and providers in developing corrective action plans to improve documentation practices, address compliance problems, or improve professional fee billing activities.
• Conducts training sessions for providers, professional fee billing staff and others on a regularly scheduled or ad hoc basis.
• Provides feedback to providers on the results of their medical record documentation reviews and gives targeted training as needed.
• Research and answers billing and documentation questions or problems submitted by faculty, departments, billing staff, and others to ensure compliance with specific payer regulations and School of Medicine / Clinical Practice Association policies and procedures.
• Regularly monitors potential billing problems and/or billing errors identified by each department’s professional fee billing office.
• Prepares and revises as needed a Compliance Training Manual for routine and special training programs.
• Assists in the development of medical record documentation standards and requirements related to clinical services billing.
• Keeps current with third party regulations with emphasis on Medicare billing, teaching physician regulations, Current Procedural Terminology, ICD-9-CM Coding, and professional fee billing.
• Performs other compliance related activities as necessary.
• May be asked to assist with training new staff or correcting the work of others. Identifies and suggests process and operational improvement.

Minimum Qualifications

• Bachelor’s Degree in health care-related or business-related field.
• Four years of auditing/billing compliance.
• One professional coding certification (CCS-P, CPC, RHIA or RHIT) required by start date.
• Demonstrated training or teaching experience.
• Additional education may substitute for required experience and additional experience may substitute for required education, to the extent permitted by the JHU equivalency formula.

Preferred Qualifications

• Experience with Epic Billing and Accounts Receivable system, EPR, Meditech, Eclypsis, IDX and other clinical information systems.
• Seven years of experience.
• Additional coding certifications.

Classified Title: Sr. Billing Compliance Auditor
Job Posting Title (Working Title): Sr. Compliance Auditor Trainer
Role/Level/Range: ATP/04/PE
Starting Salary Range: $73,300 - $128,300 Annually ($100,800 targeted; Commensurate with experience)
Employee group: Full Time
Schedule: M-F 8:30A-5PM
Exempt Status: Exempt
Location: Hybrid/Mount Washington Campus
Department name: Office of Compliance: Prof Fee Services
Personnel area: School of Medicine