The Compliance Audit & Education Specialist carries out the annual medical billing and coding compliance audit plan and ensures compliance with current government and industry audit practices and requirements.
Schedule: Full-time, Benefits Eligible
Location: Near East Office Building
431 S. 18th Street
Columbus, Ohio 43205
United States
Work environment: Hybrid - 2 days in office, 3 days remote
Responsibilities:
- Conduct billing and coding compliance audits, which includes a review of inpatient and outpatient medical records to determine appropriateness of documentation, procedure, and diagnosis coding.
- Audits involve professional and facility billing.
- Conducts analysis and be able to apply state and federal healthcare or related regulations to different questions, projects or inquiries presented to the Compliance Department.
- Investigates, responds, and communicates information regarding coding, documentation, compliance, and reimbursement questions.
- Analyzes coding issues and questions from both a compliance and reimbursement perspective.
- Provides compliance and documentation education sessions to practitioners and other staff.
- Assists in creating standardized, organization-wide educational resources regarding coding and documentation best practices.
- Delivers new provider onboarding regarding revenue cycle compliance.
Qualifications:
Education:
- Associates Degree in Health Information Management or other healthcare related field.
- Bachelors degree preferred or equivalent combination of work and educational experience.
Required Certifications:
- Certified Professional Coder (CPC), CCS-P or other similar coding certification required.
Skills:
- Proficient in Microsoft Office Suite.
- Excellent written, verbal, and interpersonal communication skills to interact with all levels of hospital staff and external agencies and individuals.
- Ability to work independently with minimal supervision required.
- Ability to work with highly confidential materials.
- Must possess high ethical standards.
- Provider education and compliance.
Experience:
- 2-3 years of professional coding experience, preferably in a pediatric healthcare setting.
- Auditing experience and hospital coding experience preferred.
- Teaching or public speaking experience desired.
- Working knowledge of Medicaid coding regulations.
The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individual so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under his/her supervision.
EOE M/F/Disability/Vet
Job Type: Full-time
Pay: From $64,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
- No weekends
Travel requirement:
Ability to Relocate:
- Columbus, OH 43205: Relocate before starting work (Required)
Work Location: Hybrid remote in Columbus, OH 43205