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Geisinger · 1 month ago

Compliance Auditor Senior - Healthcare Legal and Regulatory (Eastern United States resident)

United States

Full-time

Remote

Senior Level

7+ years exp

Geisinger is a healthcare organization seeking a Senior Compliance Auditor to ensure the integrity and accuracy of compliance audits and provide education on documentation, coding, and billing. The role involves mentoring junior auditors, conducting audits, and developing corrective action plans to address compliance risks.

Health CareHospitalMedical

Responsibilities

Performs scheduled facility and/or professional audits on the adequacy of medical record documentation to support coding (DRG, CPT, ICD 10) and billing as required by the Compliance work plan reflecting scheduled activities and target dates

Performs audits resulting from unplanned investigations

Q/A work products of peers and serve as a mentor for compliance staff

Serves as primary lead for facility/professional billing compliance education, including auditing, trending, providing audit feedback to facility/professional coding staff and providers working in the hospital and office setting

Coordinates the development and implementation of corrective action and improvement plans with critical attention to performing a root cause analysis

Prepares responses to governmental audits, evaluate findings, and manage the appeals process

Assess compliance risk areas across Geisinger entities and assist with creating the Compliance Department’s work plan

Performs research as needed to ensure organizational compliance with all applicable coding and diagnostic guidelines

Provides compliance guidance to Geisinger staff and serve as an institutional resource for Geisinger leadership, management and medical staff with a focus on federal payor billing compliance

Qualification

CCS certificationCPC certificationRHIA certificationRHIT certificationCPMA certificationMedical codingCompliance auditingRoot cause analysisCompliance educationMentoringCritical thinkingTeam collaboration

Required

One of the following coding or auditing certifications are required (CCS, CPC, RHIA, RHIT or CPMA)

Associate's Degree-Related Field of Study (Required)

Minimum of 7 years-Related work experience (Required)

Benefits

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.

Company

Geisinger

Glassdoor3.5

Geisinger is a health and wellness organization that offers orthopaedic, weight-management, and heart care services. It is a sub-organization of Risant Health.

Founded in 1915

Danville, Pennsylvania, USA

10001+ employees