Compliance Audit Coordinator

Compliance Audit Coordinator

Compliance Audit Coordinator

The External Audit Coordinator reports to the Regulatory Audit Manager. Under this supervision, the coordinator maintains a comprehensive external audit program including but not limited to MDaudit, External Audit workflow, pro-active record review, appeals, education and reporting. More specifically, the coordinator maintains, responds, and reports external audit program correspondence, activity, and results. The coordinator creates and disseminates reports and benchmarking, as well as educates stakeholders to correct deficiencies or opportunities for improvement.

Using knowledge of medical terminology, including common diseases, conditions and treatments, and care standards, plus Epic electronic medical record and audit contractor audit systems, the coordinator organizes and submits requisite medical record documentation in a manner that conveys medical necessity and coding requirements have been met.

This position is responsible for tracking the timely review and completion of each audit and remediates the audit dispositions including audit contractor questions and requests. Also, the Coordinator collaborates regularly with key stakeholders to improve documentation, implement internal controls, mitigate risk, and improve operations.

This position ensures the creation of and adherence to applicable policies and procedures relating to external audit contractors, as well as provides applicable education and training. The coordinator stays abreast of proposed and approved external audit contractor issues as well as associated regulations, interpretive guidelines, and local and national coverage determinations to assist stakeholders and safeguard the compliance program.

Education : Bachelor's Degree or equivalent Work Experience : 5 years.