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SSM Health · 1 day ago

Corporate Responsibility Auditor Senior

United States

Full-time

Remote

Mid, Senior Level

3+ years exp

SSM Health is a mission-driven organization seeking a Corporate Responsibility Auditor Senior. In this role, you will leverage your expertise in compliance and healthcare coding to enhance patient care and financial performance through investigations, process improvements, and collaboration across departments.

Health Care

Responsibilities

Initiates development and maintenance of compliance program, including compliance awareness education, implementation and maintenance of compliance policies and procedures, and monitoring of policy adherence and enforcement

Identifies, researches, summarizes, presents, educates and implements traditional and non-traditional approaches to multi-faceted issues to provide best practice

Performs or conducts compliance investigations and presents recommendations to physicians and committees

Implements process improvements and supports system wide implementation of new initiatives

Provides leadership and facilitates change in application of solutions requiring organized processes and outcomes

Documents and discusses detected deficiencies in billing and reimbursement with personnel of departments and provides recommendations to prevent future deficiencies. Develops and maintains processes to monitor program effectiveness through audits, analysis of employee hot-line reports, post office box inquires and other feedback mechanisms

Remains current with government and third party billing regulations, government initiatives on fraud and abuse, and other related legislation

Researches and performs analysis of compliance work plan. Coordinates audits/record reviews and provides education to departments when necessary. Implements corrective actions in cooperation with both clinic and business office management

Serves as resource to all internal and external customers, answering questions, researching topics and providing information regarding coding, documentation and compliance issues

Partners with other individuals/departments to foster best practice methodology and compliance

Performs other duties as assigned

Qualification

Compliance program developmentHealthcare codingBillingProcess improvementAudit coordinationRegulatory standards knowledgeLeadershipCollaborationCommunication

Required

Bachelor's degree, or equivalent combination of experience and education

Three years' experience

Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs

Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements

Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors

Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc

Frequent keyboard use/data entry

Occasional bending, stooping, kneeling, squatting, twisting and gripping

Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs

Rare climbing

None required for professional license and/or certifications

Preferred

Registered Nurse preferred

Benefits

Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).

Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.

Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members.