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    Compliance Auditor II - Springfield, United States - Mercy

    Mercy background
    Description

    Overview:

    Were a Little Different

    Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service.

    At Mercy, we believe in careers that match the unique gifts of unique individuals careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its Top 100 Places to Work.

    Overview:

    The Compliance Auditor II supports the Compliance Program across the Ministry, partnering with Legal, Human Resources and other business units as necessary. The audit process ensures compliance with required protocols, federal and state regulations and laws, Medicare/Medicaid, and Ministry-Wide policies. Performs duties and responsibilities in a manner consistent with our mission, values, and Mercy Service Standards.

    Qualifications:

    • Education: Bachelors Degree in a related field (nursing, HIM, healthcare administration, etc.) plus 2 years relevant auditing experience OR 6 years relevant auditing experience.
    • Experience:2 years relevant auditing experience
    • Musthave one or more of the following CURRENT certifications:
      • Certified Coding Specialist (CCS),
      • Certified Coding Specialist Physician (CCS-P),
      • Certified Inpatient Coder (CIC),
      • Certified Outpatient Coder (COC),
      • Certified Professional Coder (CPC),
      • Certified Risk Coder (CRC),
      • Certified in Healthcare Compliance (CHC),
      • Certified Documentation Improvement Practitioner (CDIP),
      • Certified Professional Medical Auditor (CPMA),
      • Registered Health Information Administrator (RHIA),
      • Registered Health Information Technician (RHIT).
    • Other Skills and Knowledge:
      • Working knowledge of ability to interpret medical records, UB and/or 1500 claim forms, remittance advice, and/or the charge description master (CDM).
      • Knowledge of Microsoft Word, Excel, Power Point and Outlook.
      • In-depth knowledge of the False Claims Act.
      • In-depth knowledge in one or more of the following payment methodologies: IPF, IRF, CAH, RHC, Home Health/Hospice, Infusion/Injection coding, IPPS, OPPS, MPFS, interventional radiology coding and/or Risk Adjustment.
      • Comprehensive knowledge and experience with rules and regulations pertaining to federally funded programs (e.g. Medicare and Medicaid) along with knowledge of documentation requirements for coding and billing.

    Preferred Qualifications:

    • Education: Masters or advanced degree in a related field (nursing, HIM, healthcare administration, etc.)
    • Experience: 4 years relevant auditing experienceExperience in audit education and public speaking is strongly preferred.

    We Offer Great Benefits:

    Day-one comprehensive health, vision and dental coverage, PTO, tuition reimbursement and employer-matched retirement funds are just a few of the great benefits offered to eligible co-workers, including those working 32 hours or more per pay period

    Were bringing to life a healing ministry through compassionate care.

    At Mercy, our supportive community will be behind you every step of your day, especially the tough ones. You will have opportunities to pioneer new models of care and transform the health care experience through advanced technology and innovative procedures. Were expanding to help our communities grow. Join us and be a part of it all.

    What Makes You a Good Match for Mercy?

    Compassion and professionalism go hand-in-hand with us. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. Were also collaborative and unafraid to do a little extra to deliver excellent care thats just part of our commitment. If that sounds like a good fit for you, we encourage you to apply.


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