Senior Compliance Investigation Auditor

Job description

Senior Compliance Investigation Auditor - ( 26002404 ) Description The Senior Compliance Investigation Auditor , within the Joint Office for Compliance (JOC), is responsible for the activities related to the coding, billing, and documentation investigations. This position ensures adherence to UI Health Care’s Overpayment Investigation and Return Policy, and federal rules and regulations related to coding and billing activities. Position responsibilities: Perform investigation audits in accordance with UI Health Care policies and guidelines, federal rules and regulations, and other guidelines governing compliant coding, billing, and documentation. Adhere to audit scope and perform high level, self-guided research on all required topics (coding/billing rules, federal regulations and manual guidance, commercial payor policy, internal policy, etc.) necessary to perform audit. Maintain a high level of understanding and awareness of CPT/HCPCS guidelines and federal coding and billing regulations/guidance, compliance program standards, and documentation requirements. Utilize RAT-STATS to identify random samples and statistical values in extrapolating overpayments. Analyze data based on au...