Talent.com
Compliance Auditor - SRS

Compliance Auditor - SRS

California StaffingSan Diego, CA, US
1 hour ago
Job type
  • Full-time
Job description

Certified Professional Coder (CPC)

Facility : Copley Drive City : San Diego Department : Job Status : Regular Shift : Day FTE : 1 Shift Start Time : Shift End Time : Variable AWS Hours Requirement : 8 / 40 - 8 Hour Shift Additional Shift Information : Flex hours are 6 : 00-9 : 00 am to 14 : 30-17 : 30 pm Weekend Requirements : As Needed On-Call Required : No Hourly Pay Range (Minimum - Midpoint - Maximum) : $34.170 - $44.090 - $49.370

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

  • To identify and report coding and documentation practices and make recommendations which assure the accurate reporting and documentation of services provided by entity clinical providers.
  • To support and facilitate the implementation of correct coding standards by clinical providers as established by SHC Corporate Compliance in accordance to the CMS and local MAC (Medicare Administrative Contractor) requirements.

Required Qualifications

  • 3 Years experience auditing coding and medical record documentation in an ambulatory care setting.
  • Experience developing training materials and presenting to a large group of professionals.
  • Certified Professional Coder (CPC) - AAPC OR Certified Coding Specialist Physician-based (CCS-P) - The American Health Information Management Association (AHIMA) -REQUIRED
  • Other Qualification Requirements

  • Two years of college or five years working experience in a healthcare environment related to auditing of medical records and CMS compliance - Required
  • Essential Functions

  • Auditing Participates in audit risk assessment for each division / provider to determine trends and helps management identify need for more frequent audits. Is able to analyze and create concise reports quantifying and summarizing audit findings. Presents the findings to Departments, Divisions, and at the Individual Provider level. Adheres to audit schedules and deadlines; prioritizes workload; communicates to management appropriately regarding workload and priority concerns. Utilizes internal and professional resource tools to provide quality audit results. Performs concurrent audits according to a defined audit schedule to assure that the documentation meets the standards set by CMS, local Medicare Administrative Contractor (MAC) and other third party payers. Performs provider quality audits to ensure provider is billing to meet established coding guidelines.
  • Client support Serves as a resource providing support to SRS management, physicians, administrative and support staff for coding, documentation and compliance. Provides support with TES / CM edit resolution at assigned sites and assists with coding related edit questions. Provides professional and courteous support to providers, clinical staff, PFS, via email, phone and in-person contact, answering questions and providing supporting documentation for compliance standards.
  • Communication and training Effectively communicates audit results to supervisor, manager and / or director as appropriate. Provide timely feedback and final resolution of identified issues. Schedules and provides 1 : 1 training to provider to ensure maximum coding compliance guidelines are followed. Evaluates the inpatient and outpatient training and coding areas for improvement for assigned specialties and incorporates education specific to the needs of the specialty. Develops and maintains tools, guidelines and procedures to assist in provider's understanding of requirements for medical documentation and coding. Performs training for new providers with timely feedback on their documentation.
  • Compliance Has a thorough understanding of ICD-10 and CPT coding guidelines. Protects all work products, working papers, personal lap top, and other related documents and / or portable electronic data systems in accordance with SHC and regulatory privacy and confidentiality guidelines. Stays current with Medicare updates and specialty specific professional services updates; communicates changes to management.
  • Data collection and reporting Designs and develops reports within a specified timeframe. Analyzes trends while reviewing documentation and communicates to management. Reports findings identified during documentation reviews and includes official references related to the findings.
  • Education Reviews coding publications for changes, clarifications and / or information pertinent to the medical group's specialties / services. Attends and participates in job related conferences, seminars and workshops to enhance skills and keep current on coding and documentation changes. Presents to management complete supporting documentation associated with areas of concern.
  • Knowledge, Skills, and Abilities

  • Excellent working knowledge of CPT, ICD-10 and HCPCS codes is required.
  • Thorough understanding of Medicare, insurance documentation, and compliance and coding requirements.
  • Expert knowledge of MS Office which includes : Excel, Word, and PowerPoint.
  • Ability to educate and train all levels of clinical and professional staff.
  • Excellent interpersonal skills verbal and written, with the ability to communicate to all levels of staff within the organization.
  • Ability to produce high quality work / reports with minimal error rate.
  • Professional approach to work including ability to exercise mature judgement and maintain confidentiality in all activities.
  • Sharp HealthCare is an equal opportunity / affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class.

    Create a job alert for this search

    Compliance Auditor • San Diego, CA, US

    Related jobs
    • Promoted
    Remote Investment Analyst – AI Trainer ($50-$60 / hour)

    Remote Investment Analyst – AI Trainer ($50-$60 / hour)

    Data AnnotationSan Marcos, California
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...Show moreLast updated: 30+ days ago
    • Promoted
    Partner- Bankruptcy and Restructuring

    Partner- Bankruptcy and Restructuring

    EisnerAmperLa Jolla, CA, United States
    Full-time
    At EisnerAmper, we look for individuals who welcome new ideas, encourage innovation, and are eager to make an impact.Whether you're starting out in your career or taking your next step as a seasone...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Licensed Mental Health Therapist (LCSW) - Hybrid Role - Santa Ysabel, CA

    Licensed Mental Health Therapist (LCSW) - Hybrid Role - Santa Ysabel, CA

    LifeStance HealthSanta Ysabel, CA, US
    Full-time
    We are actively looking to hire talented therapists in the Oceanside area, who are passionate about patient care and committed to clinical excellence. Wanting to deliver high quality behavioral heal...Show moreLast updated: 18 hours ago
    • Promoted
    Licensed Mental Health Therapist (LMFT, LCSW, LPCC) - Alpine, CA

    Licensed Mental Health Therapist (LMFT, LCSW, LPCC) - Alpine, CA

    LifeStance HealthAlpine, CA, US
    Full-time
    At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make lives better. Our mission is to help people lead healthier, more fulfilling lives...Show moreLast updated: 1 day ago
    • Promoted
    • New!
    Licensed Mental Health Therapist (LMFT & LCSW) - Hybrid Role - Alpine, CA

    Licensed Mental Health Therapist (LMFT & LCSW) - Hybrid Role - Alpine, CA

    LifeStance HealthAlpine, CA, US
    Full-time
    We are actively looking to hire talented therapists in the San Diego area, who are passionate about patient care and committed to clinical excellence. Wanting to deliver high quality behavioral heal...Show moreLast updated: 2 hours ago
    • Promoted
    • New!
    Licensed Mental Health Therapist (LCSW) - Hybrid Role - Alpine, CA

    Licensed Mental Health Therapist (LCSW) - Hybrid Role - Alpine, CA

    LifeStance HealthAlpine, CA, US
    Full-time
    We are actively looking to hire talented therapists in the Oceanside area, who are passionate about patient care and committed to clinical excellence. Wanting to deliver high quality behavioral heal...Show moreLast updated: 18 hours ago
    • Promoted
    • New!
    Licensed Mental Health Therapist (LMFT & LCSW) - Hybrid Role - Dulzura, CA

    Licensed Mental Health Therapist (LMFT & LCSW) - Hybrid Role - Dulzura, CA

    LifeStance HealthDulzura, CA, US
    Full-time
    We are actively looking to hire talented therapists in the San Diego area, who are passionate about patient care and committed to clinical excellence. Wanting to deliver high quality behavioral heal...Show moreLast updated: 2 hours ago
    • Promoted
    Remote Financial Advising Expert - AI Trainer ($50-$60 / hour)

    Remote Financial Advising Expert - AI Trainer ($50-$60 / hour)

    Data AnnotationSan Marcos, California
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...Show moreLast updated: 11 days ago
    • Promoted
    Remote Finance Director - AI Trainer ($50-$60 / hour)

    Remote Finance Director - AI Trainer ($50-$60 / hour)

    Data AnnotationCarlsbad, California
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...Show moreLast updated: 30+ days ago
    • Promoted
    Remote FP&A Manager – AI Trainer ($50-$60 / hour)

    Remote FP&A Manager – AI Trainer ($50-$60 / hour)

    Data AnnotationPoway, California
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...Show moreLast updated: 30+ days ago
    • Promoted
    Remote Senior FP&A Analyst - AI Trainer ($50-$60 / hour)

    Remote Senior FP&A Analyst - AI Trainer ($50-$60 / hour)

    Data AnnotationEscondido, California
    Remote
    Full-time +1
    We are looking for a finance professional to join our team to train AI models.You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of ...Show moreLast updated: 11 days ago
    Financial Compliance Auditor : 25-05150

    Financial Compliance Auditor : 25-05150

    Akraya IncSan Diego, California, United States
    Full-time
    Quick Apply
    Primary Skills : Auditing-Advanced, Excel-Intermediate, Analysis-Advanced, Documentation-Intermediate, Compliance-Advanced. Location : Atlanta, GA / San Diego / Mountain view, CA(#LI-HYBRID).We are seekin...Show moreLast updated: 30+ days ago
    • Promoted
    Sr. Solutions Architect

    Sr. Solutions Architect

    LeidosEncinitas, CA, US
    Full-time
    The Leidos Navy and Marine Corps Business Area is seeking an energetic and dynamic Sr.Solutions Architect in San Diego, CA. Solutions Architect, you will support the BA CTO across all technology ini...Show moreLast updated: 1 day ago
    • Promoted
    Licensed Mental Health Therapist (LMFT, LCSW, LPCC) - Santa Ysabel, CA

    Licensed Mental Health Therapist (LMFT, LCSW, LPCC) - Santa Ysabel, CA

    LifeStance HealthSanta Ysabel, CA, US
    Full-time
    At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make lives better. Our mission is to help people lead healthier, more fulfilling lives...Show moreLast updated: 1 day ago
    • Promoted
    Air Interdiction Agent

    Air Interdiction Agent

    U.S. Customs and Border ProtectionAlpine, CA, United States
    Full-time
    Pilot—CBP Air Interdiction Agent.Air and Marine Operations (AMO), a component of U.Customs and Border Protection (CBP), offers skilled Pilots interested in law enforcement an opportunity to work wi...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Compliance Auditor - SRS

    Compliance Auditor - SRS

    San Diego StaffingSan Diego, CA, US
    Full-time
    Certified Professional Coder (CPC) - AAPC.Facility : Copley Drive City : San Diego Department : Job Status : Regular Shift : Day FTE : 1 Shift Start Time : Shift End Time : Variable AWS Hours Requirement : ...Show moreLast updated: 15 hours ago
    Sr. Auditor

    Sr. Auditor

    Hatch Global SearchSan Diego, California, US
    Full-time
    Quick Apply
    Job DescriptionJob Description.This is your chance to join a highly respected Southern California CPA team that values excellence, collaboration, and professional growth. If you thrive in public acc...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Licensed Mental Health Therapist (LMFT & LCSW) - Hybrid Role - Guatay, CA

    Licensed Mental Health Therapist (LMFT & LCSW) - Hybrid Role - Guatay, CA

    LifeStance HealthGuatay, CA, US
    Full-time
    We are actively looking to hire talented therapists in the San Diego area, who are passionate about patient care and committed to clinical excellence. Wanting to deliver high quality behavioral heal...Show moreLast updated: 2 hours ago