Apply on Employer Site

Moffitt Cancer Center · 1 day ago

Compliance Auditor

Tampa, FL

Full-time

Onsite

Mid Level

3+ years exp

Moffitt Cancer Center is seeking a Compliance Auditor to conduct audits ensuring the integrity of billing for professional and hospital services. The role involves evaluating documentation and coding practices, communicating findings, and providing education to stakeholders.

Health Care

Responsibilities

Plans and performs scheduled and unscheduled professional or hospital compliance department audits, including accuracy and adequacy of documentation and coding related to physician or hospital (inpatient and outpatient) billing and/or medical necessity reviews

Evaluates the appropriateness of services and procedures billed based on supporting documentation

Prepares written reports of audit findings and recommendations and presents to appropriate stakeholders; evaluates the adequacy of management corrective action to improve deficiencies; maintains audit records

Conducts risk assessments to define audit priorities by evaluating previous audit findings, management priorities, coding utilization patterns, national normative data, CMS and CCI initiatives, OIG work plans and advisories and healthcare industry best practices

Develops compliance training content and provides one-on-one and group training to faculty physicians, advanced practitioners, billing and coding staff and others

Conducts compliance orientation training for new providers

Researches, abstracts and communicates federal, state and payer documentation, billing and coding rules and regulations. Serves as institutional subject matter expert and authoritative resource in these areas

Qualification

Health Information ManagementCoding CertificationTechnical Coding/AuditingMedicare/Medicaid KnowledgeCompliance Training DevelopmentRisk AssessmentCommunication SkillsTeam CollaborationIndependent Work

Required

Bachelor's degree in Health Information Management, Business or related field

Three (3) years of experience in physician and/or hospital technical coding/auditing, medical necessity reviews, or related work

In lieu of a bachelor's degree, HS Diploma/GED and seven (7) years of relevant experience will be considered

Must possess an AAPC or AHIMA coding certification (CPC, CCS, CCS-P, COC, or RHIA, etc.)

Extensive knowledge of evaluation and management and/or hospital facility fee coding and auditing

Knowledge of Medicare and Medicaid documentation and coding rules and guidelines

Ability to interpret and apply documentation and coding rules and regulations and to interpret medical record progress notes, handwritten and electronic chart entries, provider orders and other related documentation

Understanding of institutional risks and appropriate judgment to use a risk-based approach in planning and executing duties

Ability to work in both independent contributor and team roles (both as a team leader and team member)

Ability to communicate complex and potentially sensitive issues to all levels of management including senior leadership