Job Summary
The Office of Compliance Services is seeking to hire a Senior Professional Auditor & Trainer. In this key role, you will provide support to the work plan and compliance functions of the Professional Revenue Cycle Compliance Program Division. Primary duties include:
Participate in annual compliance risk assessment and completes defined work plan items:
Auditing and Monitoring
research, investigations, participate in the claims review process
Training and Education
- Research materials and methods, developing training materials, updating or modifying existing materials
- Organize and design training events; prepare and present completion reports
- Collect and analyze documentation, participate in interviews and maintaining relevant work papers
- Record all findings, result and data related to investigations in department GRC database and share information as appropriate
- Draft, present as requested, the investigation report
- CPC certification required, with additional certification such as CPMA preferred
- Two years of experience working in an academic medical center environment with emphasis on professional compliance activities, including but not limited to: auditing, monitoring, investigation and training - strongly preferred
- Advanced degree preferred (e.g. BS in Healthcare Administration/Management/Clinical
- Demonstrated expertise in medical terminology, including anatomy and physiology
- Demonstrated expertise in healthcare coding (CPT, ICD-10, HCPCS), with knowledge of professional billing, coding and documentation practices in inpatient and outpatient settings
- Demonstrated expertise in end to end revenue cycle components
- Solid understanding of federal, state and local billing, coding and documentation laws and regulations
- Demonstrated knowledge of the essential elements of an effective compliance program
- Excellent ability to communicate in writing and speaking
- Strong organizational skills and task management