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Compliance Auditor-Facility Billing

Company: Southcoast Health System
Location: New Bedford
Posted on: June 13, 2021

Job Description:

Work for One of the World#s Best Hospitals! In 2019 and 2020, Newsweek named Southcoast Health among the World#s Best Hospitals (Charlton Memorial, St. Luke#s, and Tobey). In addition, Southcoast Health was voted by readers as South Coast Media Group#s Best Place to Work in 2019 and 2020.# Why? Because we have some of the most talented people in the world! We are searching for a Compliance Auditor- Facility Billing to, under the direction of the Manager- Corporate Compliance # Internal Audit, be responsible for the planning, organizing, and completion of hospital revenue integrity compliance auditing and education activities required to comply with federal guidelines and other compliance -related requirements.# Additional job duties include but not limited to: # Identify lost revenue opportunities and any overpayments made due to errors in coding, insufficient medical record documentation, etc. Increase and strengthen health care providers# awareness and understanding of medical record documentation guidelines and coding principles. Serve as a role model for ethical management behavior and promote an awareness and understanding of the System#s Code of Conduct and Privacy and Corporate Compliance Program. Assist the Manager, Corporate Compliance # Internal Audit in assessing risk and developing an auditing plan to support the overall compliance plan. #Interact with all levels of management within the Health System. Work independently under limited supervision with emphasis on initiative and independent judgment. Provide functional or technical supervision of other employees in the same or related classifications where supervisory responsibility is limited to occasional direction, guidance, explanation, etc. # Education and/or Experience Requirements: A Bachelor#s Degree is preferred. Extensive knowledge of hospital inpatient and outpatient coding and billing compliance required (ICD-10, DRG, APC, CPT and HCPCS) and AP Federal and state regulations pertinent to a Health System. Knowledgeable in both Medicare Part A and Part B. Hierarchical Condition Category Coding is a plus. A good working knowledge of healthcare practices, operations and coding compliance. Specifically, a good working knowledge of medical terminology, patient care services, and clinical documentation. Interpersonal skills to interact appropriately with various levels of management, mid-level providers and physicians. Proficient with Microsoft Word, Excel, PowerPoint and Outlook. Minimum of 5 years of auditing/coding experience is required. At least one of the following certifications is required: Certified Coding Specialist (CCS), Certified Professional Medical Auditor (CPMA) or Certified Medical Coder (CMC). Certified Professional Coder (CPC), a plus. # Southcoast Health is a community healthcare system with multiple access points, offering an integrated continuum of health services throughout Southeastern Massachusetts and Rhode Island. By uniting a single purpose and building an integrated system of services and resources, we have become one of the largest and fastest-growing health systems in Massachusetts. # #Together We Are More. With more than 7,500 employees, Southcoast Health is the largest employer in Southeastern Mass., and the 18th largest employer in the Commonwealth, according to the Boston Business Journal. We strive for a culture of health and well-being that recognizes, respects, and celebrates the rich diversity of one another and the communities we serve. We are committed to providing our employees in Massachusetts and Rhode Island with optimal benefits that promote a healthy work/life balance and add value to our employees# lives. Generous Earned Time Off Package Health, Dental and Vision Insurance Tuition Assistance Short Term and Long-Term Disability Insurance Life # AD#D insurance Flexible Spending Accounts 403B Retirement Plan with match HealthQuest Wellness Program Employee Assistance Program Employee Discount Program Career Development Opportunities Diversity, Equity and Inclusion Council *Available to regular status employees who are scheduled to work a minimum of 24 hours. Available to regular status employees who are scheduled to work a minimum of 20 hours. #Are you ready to make a difference in your community? Join us to be More than medicine! Southcoast Health is an Equal Opportunity Employer # #Under the direction of the Executive Director, Corporate Compliance and Internal Audit or designee, oversee a comprehensive program of hospital and professional billing compliance and compliance related auditing and education within the Southcoast Health System. Oversight for the development, implementation and continuous process improvement of a comprehensive revenue cycle compliance audit and education plan. Oversee education efforts across the system on revenue compliance requirements, documentation enhancements, and Medicare/Medicaid billing regulations.Provide functional or technical supervision to other employees in the same or related classifications where supervisory responsibility is limited to occasional direction, guidance, explanation, etc. Serve as a role model for ethical conduct.Education and/or Experience: A Bachelors Degree in an appropriate field or equivalent combination of related knowledge and experience required. CPC, RHIA, or CSC credentials required. Duties require extensive knowledge of ICD-10 and CPT codes, and DRGs and federal and state regulations pertinent to a Health System. Hierarchical Condition Category Coding is a plus. Position requires formal education in coding, anatomy, physiology, and medical terminology. Computer skills required Word, Excel, PowerPoint and Outlook. Over five years of auditing/coding experience, is also required.

Keywords: Southcoast Health System, New Bedford , Compliance Auditor-Facility Billing, Other , New Bedford, Massachusetts

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