Compliance Provider Educator/Auditor - Integrity & Compliance

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Human Resources

Important Applications Instructions :

Please complete this application in entirety by providing all of your work experience, education and certifications /

license. You will be unable to edit / add / change your application once it is submitted.

Job Requisition ID : R00032374

R00032374

Job Category :

Professional and Technical

Organization :

Integrity & Compliance-Executive Director

Location / s : Main Campus Jackson

Main Campus Jackson

Job Title :

Compliance Provider Educator / Auditor - Integrity & Compliance

Job Summary :

Provide extensive education and training to individual providers and entire departments on regulatory guidelines, teaching physician rules, and physician coding and billing requirements.

To develop educational materials specific to individual providers and departmental needs. To perform secondary audits on charts / claims after analysts initial review to determine accuracy of errors.

Education & Experience

Bachelor's degree in Health Information Management or related field plus three years of ICD and CPT coding, teaching physician guidelines, healthcare record auditing, and physician billing experience or equivalent combination of education / experience.

Certification from American Health Information Management Association (AHIMA), or American Academy of Professional Coders (AAPC).

Certifications, Licenses or Registration Required : Certification from American Health Information Management Association (AHIMA), or American Academy of Professional Coders (AAPC).

Knowledge, Skills & Abilities

Current and extensive knowledge of ICD and CPT coding principles and guidelines, medical terminology, and physician billing rules and regulations.

Strong verbal and written communication and presentation skills and experience in conducting compliance training. Skills in applying regulatory guidelines to identify and solve problems.

Responsibilities

• Conducts onboarding and training sessions to educate all billing providers on regulatory compliance guidelines, coding and billing requirements and teaching physician rules and regulations.
• Develops educational and training materials to individual providers and departments that focus on coding, billing, and teaching physician guidelines.
• Collaborates with management to identify aberrant trends in coding and billing within the physician auditing area to include provider and staff concerns.
• Assists with the resolution of compliance issues and responds to information requests from providers and other personnel.
• Ensures continued compliance with state and federal requirements with knowledge of existing and new legislation and recommends new policies and procedures when necessary.
• Performs second audits on claims / charts reviewed by staff to determine auditing deficiencies.
• The duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive.

Management retains the right to add or change duties at any time.

Physical and Environmental Demands

Requires occasional working hours significantly beyond regularly scheduled hours, occasional travelling to offsite locations, occasional activities subject to significant volume changes of a seasonal / clinical nature, constant work produced subject to precise measures of quantity and quality, occasional bending, occasional lifting and carrying up to 50 pounds, occasional crouching / stooping, occasional driving, constant sitting, frequent standing, occasional twisting, and frequent walking.

occasional-up to 20%, frequent-from 21% to 50%, constant-51% or more)

Time Type : Full time

Full time

FLSA Designation / Job Exempt :

Pay Class : Salary

Salary

FTE % : Work Shift :

Work Shift :

Benefits Eligibility :

Benefits Eligible

Grant Funded : Job Posting Date :

Job Posting Date : 02 / 2 / 2024

02 / 2 / 2024

Job Closing Date (open until filled if no date specified) :