- Experience conducting independent audits to assess risk with regulatory standards and writing formal reports
- Minimum of five (5) years' experience in an acute care inpatient and/or outpatient settings
- Experience conducting medical coding, medical necessity, claims denial, bundling, and reimbursement audits
- Working knowledge in the assignment of ICD-9-CM, ICD-10-CM, CPT, HCPCS and MS-DRG/APC classifications and reimbursement methodologies
- Strong verbal and written communication skills
- Strong analytical and critical thinking skills
- Ability to work independently
- Ability to handle multiple priorities and deadlines
- Associate's degree in Business, Healthcare, Nursing (ASN) or other related field required
- Bachelor's Degree in Business, Healthcare, Nursing preferred
- Bachelor of Science in Nursing (BSN) preferred
- Master of Science in Nursing (MSN) preferred
- One of the following coding certifications through American Health Information Management Association or the American Academy of Professional Coders required:
- Certification in Health Care Compliance (CHC) preferred
- Registered Health Information Technician (RHIT) preferred
- Registered Health Information Administrator (RHIA) preferred
- Certified Internal Auditor (CIA) preferred
- Certified Health Care Compliance (CHC) preferred
- Certified Healthcare Auditor (CHA)
- Certified Healthcare Internal Audit Professional (CHIAP) preferred
- Meet annual requirements to maintain certification, license and registrations
- Strong working knowledge in Microsoft Word, Excel, Power Point and Outlook required
- Experience with electronic medical records and billing platforms
- Ability to learn new systems quickly
-
Compliance Auditor
2 weeks ago
SCP Health Atlanta, United StatesDescription · At SCP Health, what you do matters As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 ...
-
Compliance Auditor
2 weeks ago
Grady Health System Atlanta, United StatesGrady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages on your career, you can find a rewarding career at Grady · SUMMARY · As a member of the Compliance team, the Compliance Auditor is resp ...
-
Compliance Senior Auditor
2 weeks ago
Sevita Atlanta, United States Full timeThe MENTOR Network is now Sevita. We have a different name, but the same mission, and a renewed sense of purpose. At Sevita we provide home and community-based health care services and support for adults, children, and their families across the United States. Join us in work that ...
-
Compliance Senior Auditor
1 week ago
Sevita Atlanta, United StatesAt Sevita we believe that everyone deserves to live well. For more than 50 years, our team members have provided home and community-based health care for adults, children and their families across the United States. As a member of our corporate team, you'll help shape the work th ...
-
Compliance Clinical Senior Auditor
1 week ago
Sevita Atlanta, United StatesAt Sevita we believe that everyone deserves to live well. For more than 50 years, our team members have provided home and community-based health care for adults, children and their families across the United States. As a member of our corporate team, you'll help shape the work th ...
-
Senior Auditor Contract Compliance
2 weeks ago
PRGX Global, Inc. Atlanta, United StatesJob Description · Job Description · This position is REMOTE, but prefer candidate to be in one of the following locations: · Chicago, IL · Houston, TX · Dallas, TX · ABOUT PRGX · Headquartered in Atlanta, Georgia, PRGX Global, Inc. is the world's leading provider of recovery au ...
-
Senior Auditor Contract Compliance
2 weeks ago
PRGX Global, Inc. Atlanta, United StatesJob Description · Job Description · ABOUT PRGX · Headquartered in Atlanta, Georgia, PRGX Global, Inc. is the world's leading provider of recovery audit services. We are also innovating, discovering and delivering hidden profits to our clients by mining data for key financial insi ...
-
Compliance Senior Auditor
1 week ago
Sevita Atlanta, United StatesAt Sevita we believe that everyone deserves to live well. For more than 50 years, our team members have provided home and community-based health care for adults, children and their families across the United States. As a member of our corporate team, you'll help shape the work th ...
-
Senior Compliance Auditor
4 weeks ago
Centene Corporation Atlanta, United StatesYou could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flex ...
-
Compliance Auditor
1 week ago
PruittHealth Corporation, Inc. Norcross, United StatesThe Compliance Auditor (CA) reports directly to the Vice President of Compliance (VPC) to conduct compliance audits for Health Care Centers (HCC), Hospice, Home Health and/or SOURCE/ CCSP service lines. The CA performs routine and focused internal co Compliance, Auditor, Audit, N ...
-
Compliance Auditor
1 week ago
PruittHealth Norcross, United StatesJOB PURPOSE: · The Compliance Auditor (CA) reports directly to the Vice President of Compliance (VPC) to conduct compliance audits for Health Care Centers (HCC), Hospice, Home Health and/or SOURCE/CCSP service lines. The CA performs routine and focused internal compliance investi ...
-
Senior Auditor Contract Compliance
1 week ago
PRGX Global Atlanta, United StatesHeadquartered in Atlanta, Georgia, PRGX Global, Inc. is the world's leading provider of recovery audit services. We are also innovating, discovering and delivering hidden profits to our clients by mining data for key financial insights. The Company operates and serves clients in ...
-
Compliance Accounting Auditor
3 weeks ago
MH Miles & Company Douglasville, United StatesJob Description · Job DescriptionMH Miles Company, CPA, PC is a certified public accounting firm with offices in Decatur, GA, Douglasville, GA, and Washington, DC. Our firm and its affiliates consist of certified public accountants, certified fraud examiners, management consultan ...
-
Compliance Auditor
1 week ago
PruittHealth Norcross, United StatesJOB PURPOSE: · The Compliance Auditor (CA) reports directly to the Vice President of Compliance (VPC) to conduct compliance audits for Health Care Centers (HCC), Hospice, Home Health and/or SOURCE/CCSP service lines. The CA performs routine and focused internal compliance invest ...
-
Compliance Specialist and Auditor
2 weeks ago
Advanced Urology Snellville, United StatesJob Description · Job DescriptionDr. Jitesh Patel started Advanced with one goal in mind – to do the right thing. We aim to continue that mission here every day. We know that our employees are what makes the difference in the care of our patients – and we always put our employees ...
-
Compliance Specialist and Auditor
2 weeks ago
Advanced Urology Snellville, United StatesDr. Jitesh Patel started Advanced with one goal in mind to do the right thing. We aim to continue that mission here every day. We know that our employees are what makes the difference in the care of our patients and we always put our employees and our patients first. · Come work ...
-
IT Compliance Senior Analyst
2 weeks ago
Crawford & Company Atlanta, United States Permanent Full timePosition Summary · The IT Senior Compliance Analyst reports directly to the IT Compliance Director is responsible for a combination of driving the efforts as well as being hands-on in completing multiple IT risk assessment efforts. This individual will be part of a highly visible ...
-
PRGX Global Inc. Atlanta, United StatesThe Governance, Risk and Compliance Manager (Security) specializes in third-party risk assessments, ISO27001 audits, SOC2 audits, and client-conducted risk assessments. The position plays a pivotal role in maintaining and enhancing PRGX's governance, risk and compliance framework ...
-
Vice President Finance
1 week ago
Staffing Technologies Atlanta, United StatesJob Title: Vice President of Finance · Location: Atlanta, GA (Hybrid) · Job Duration: Full Time · Primary Skills: · Strong leadership and strategic vision in finance and accounting within the Technology, Media, and Telecommunications (TMT) sector. · Mastery of financial planning ...
-
Security and Compliance Analyst
1 week ago
Wolters Kluwer DXG U.S., Inc. Atlanta, United States Full timeSecurity Risk and Compliance Analyst will operate within a divisional security team reporting to the Director of Information Security. Analyst will be responsible for risk assessment, reporting and audit of Customer facing applications supporting the Tax and Accounting (TAA) and ...
Compliance Auditor - Atlanta, United States - Grady Health System
Description
Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages on your career, you can find a rewarding career at GradySUMMARY
As a member of the Compliance team, the Compliance Auditor is responsible for leading and conducting key activities of Grady Health System's audit program.
The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters and other compliance issues as directed by the Compliance Director and the Chief Compliance Officer.
This position requires effective communication with internal stakeholders and external auditors. Candidate should possess excellent organization skills to ensure accuracy and timeliness of audit results.QUALIFICATIONS
EDUCATION
o Certified Coding Specialist - Physician (CCS-P)
o Certified Professional Coder (CPC, formerly CPC-H)
o Certified Outpatient Coding (COC)
COMPUTER SKILLS:
#J-18808-Ljbffr