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The Compliance Auditor II will assist in the overall quality, compliance, and auditing activities to ensure compliance of standard operating procedures, corporate policies, industry standards, and applicable federal and state laws. Conducts audit activities, reporting and communicates audit findings. Works in conjunction with Compliance Director on compliance work plans, internal and external audits and reviews, and provides assurance that the organization is operating in an efficient and effective manner.
Job Responsibility:
Manages compliance audit activities pertaining to compliance and coordinates with Corporate Compliance Director and Senior Leadership as it relates to such audits
Responsible for answering inquiries related to professional documentation, coding, and billing regulatory requirements
Assist with data analysis to determine root cause of reported or identified issues and determine level of escalation required
Performs and follows established audit work steps and procedures
Gather all relevant information for potential compliance issues, determine underlying causes, and relate information from different sources to draw logical conclusions
Maintain a current understanding of regulatory trends and changes in compliance and regulatory guidelines that affect CHRISTUS and its subsidiaries
Document all issues received, actions taken, and resolutions
Collaborates with Compliance Director, VP, Compliance on external audits and reviews
Coordinates and performs timely medical record and claims reviews across CHRISTUS Health departments
Works jointly with Compliance Directors, VP, Compliance on the compliance work plan, risk assessments, and quarterly Board Committee reports
Assist with the development of dashboards, written reports, or other deliverables
Provides feedback to HIM, Case Management, Patient Financial Services (PFS), Revenue Cycle, physicians and Hospital and Clinic operations regarding charging, documentation, patient status and coding issues
Perform audits and reviews, identify process improvements, and streamline processes
Communicates compliance/audit activities and outcomes to departments
Assists Compliance Director on OIG and other government audits/reviews and other compliance-related work
Maintains confidentiality and discretion regarding all work matters
Takes personal responsibility to ensure compliance with all policies, procedures and standards
Performs all duties in a manner that protects the confidentiality of patients
Requirements:
Associate's degree required
Strong interpersonal and written and verbal communications skills required
Strong data analytics and interpretation skills preferred
Knowledge and experience in using EPIC, Word, Excel, PowerPoint, PowerBI and similar Office programs preferred
RHIT, RHIA, RN, CHC, CPC or similar credential preferred
Nice to have:
Bachelor's degree preferred
Strong data analytics and interpretation skills preferred
Knowledge and experience in using EPIC, Word, Excel, PowerPoint, PowerBI and similar Office programs preferred
RHIT, RHIA, RN, CHC, CPC or similar credential preferred