Compliance Auditor

Compliance Auditor

Pay Range : $47.69 - $67.19

SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.

Working at SEARHC is more than a job, it's a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health, dental, and vision benefits, life insurance and long and short-term disability, and more.

Ensure SEARHC meets federal and state regulations and internal policies in regard to healthcare coding, documentation, and billing practices. Review health records to verify coding and clinical documentation meets applicable coding and billing requirements, Medicare / Medicaid regulations, federal and state laws, and SEARHC policy.

Key Essential Functions and Accountabilities of the Job

• Conduct Audits : Review health record documentation, claims, coding, policies and processes to identify compliance or non-compliance with SEARHC policies, state and federal laws and regulation, Medicare / Medicaid regulations, and national coding standards.
• Analyze Data : Examine data to identify patterns and trends for compliance or non-compliance.
• Identify Risk : Analyze audit results, data, policies, and processes to assess risk.
• Develop Audit Plans : Create audits based on risk assessments, billing practices, new services, Medicare / Medicaid risk areas, Medicare / Medicaid audits, and RAC and PERM audits.
• Prepare Reports : Document audit findings and recommendations. Present reports to the Compliance Director, Chief Legal Officer, Division Vice President, Compliance Committee and Accreditation Governing Body.
• Training and Education : Prepare and provide training and education to staff in response to audit findings, and staff inquiries.

Other Functions

Education, Certifications, and Licenses Required

Experience Required

Knowledge of

Skills in

Ability to

Travel Required

Required Certifications