Compliance Auditor and Educator

SUMMARY:The
Compliance Auditor and Educator will participate in the performance of medical
record audits of all College of Medicine Departments involved with billing third-party
payers. Will also serve as an educator for
physicians, residents, and billing/coding staff regarding coding and
documentation requirements.

ESSENTIAL DUTIES AND RESPONSIBILITIES: include the following. Other duties me be assigned.

• Perform annual audits of documentation
  of inpatient and office medical records by physicians, residents, nurse
  practitioners and other providers.
• Educate the physicians, residents, nurse
  practitioners and other providers of coding and documentation issues based on
  the audits.
• Report audit results to the Associate
  Dean, Compliance Committee, and Board of Directors as appropriate.
• Provide coding and documentation
  guidelines to the physicians, residents, nurse practitioners, and billing
  employees as needed.
• Provide an orientation to all new hire
  physicians on the compliance plan and policies, teaching physician guidelines.
• Research problem areas and provide
  solutions related to coding and payer requirements.

EDUCATION AND/OR EXPERIENCE:Knowledge of CPT, ICD-10-CM
and HCPCS coding systems and guidelines.
Basic knowledge of HIPAA guidelines necessary. Experience in an academic and/or multi-specialty
environment. Knowledge of medical
terminology, physician billing, third-party regulations and auditing
procedures. High school diploma or GED
required. CPC or CCS required, plus 3 years
of coding and billing experience. CPMA
is preferred; this certification would be required to obtain within 6 months of
employment. Bachelors degree and/or previous auditing experience preferred but
not required.

OTHER SKILLS AND ABILITIES:Working knowledge of computers, keyboards and
printers. Skill in composition,
compiling, and preparing a variety of correspondence, documentation, reports,
and other materials. Ability
to establish and maintain an effective working relationship with faculty
members, staff, patients and other third parties. Ability to concentrate under high demands and
listen effectively. Ability to organize
tasks, work as a team member and independently with a variety of professional
disciplines. Convey a professional and
positive image and attitude.

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