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Compliance Clinical Senior Auditor
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Full-time
- The Senior Clinical Compliance Auditor is responsible for developing, auditing plans, and collaborating with Operations and Revenue Cycle in auditing/monitoring compliance requirements across all Company business units and service lines.
- Collaborates with Ethics and Compliance Officers to contribute to projects related to the Compliance Audit, Self-Monitoring, Data Mining and Risk Assessment programs.
- Coordinates with clinical operations, revenue cycle departments to ensure accounts audited reflect proper documentation, charge capture, coding, billing and payment.
- Contributes to the identification and reduction of the Company's coding compliance risks, billing inaccuracies, and/or denials by coordinating independent reviews and assessments of the organization's professional coding and billing transactions, processes, and internal controls for coding completeness and accuracy.
- Coordinates and executes pre- and post-payment audits of medical records and associated clinical documentation to ensure proper charge capture and billing in accordance with standard state, federal, and internal reimbursement policies, principles, and mandates.
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