Prof Coding Compliance Auditor

Job description

Description Primary function: Reporting to the Manager, Compliance Audit and Analysis, develops and executes audit, monitoring, and education for professional billing, coding and documentation programs that confirm compliance, identifies reimbursement implications, and provides billing providers with relevant and timely information regarding audit results and risk areas. Serves as a resource for providers on professional billing and coding. Principal duties and responsibilities: - Prepares and oversees professional billing and coding components of the Compliance work plan reflecting scheduled activities and target dates. - Leads focused audits and reviews to assess adherence with professional billing compliance policies, legal and regulatory requirements, and to identify and evaluate risk areas. - Assists in development of organizational compliance auditing and monitoring activities for professional billing and coding, including periodic reviews of the individual department auditing and monitoring functions. - Coordinates sample reviews to ensure codes that were billed are properly supported by appropriate provider documentation. - Creates audit result reports to be reviewed with p...