Compliance Auditor
Description
At SCP Health, what you do matters
As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.
Why you will love working here:
- Strong track record of providing excellent work/life balance
- Comprehensive benefits package and competitive compensation
- Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.
What you’ll be doing:
The Compliance Auditor reports to the Compliance Manager and is responsible for auditing billing and coding processes to ensure compliance with Medicare and other governmental payor rules and regulations.
- Conducts regular baseline, focused, follow-up and representative sample audits as outlined in the annual audit plan.
- Develops reports of audit findings for each audit performed.
- Works collaboratively with other departments to gather information needed for each audit as well as to implement corrective action plans.
- Maintains knowledgeable of all healthcare laws and regulations, including but not limited to Medicare, Medicaid and other governmental payor rules and regulations.
- Assists with the development of policies and procedures related to auditing.
- Assists in the implementation and maintenance of analytics and trending of audit findings.
- Contributes to Company-wide Risk Assessment process.
- Exhibits the Companys Core Values and complies with the Code of Conduct.
Who/What we are looking for:
- 1-3 years of experience in compliance.
- Billing, coding, and audit experience a plus
- CPC/CCS preferred
- RN or RHIA/RHIT a plus
- Strong analytical, research and problem-solving skills. Must be able to recognize areas of the Company impacted by laws and regulations.
- Strong knowledge base in complete and accurate clinical documentation.
- Strong knowledge of Federal and State health care regulations.
- The ability to accurately interpret/implement regulatory standards and legal requirements.
- Strong verbal and written communication skills.
- Strong computer skills (excel, and handling large data sets)
- Ability to work independently and handle multiple tasks/projects at the same time.
- Bachelor Degree Required
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