Compliance Auditor

🔥 31 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

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Precision Healthcare Specialists

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51 - 200 employees

🏥 Healthcare

Healthcare

Precision Healthcare Specialists is a Southwest Florida medical specialty group that connects patients with cohesive teams of surgeons and physicians across multiple specialty areas. Their services include breast surgical oncology, colorectal surgery, dermatology, otolaryngology (ENT), orthopaedic surgery, pulmonology, urology, general surgery, audiology and endocrinology, delivered via inpatient and outpatient tests and procedures, patient portals, online payments, and consultation requests. The organization emphasizes personalized, compassionate care and coordinating specialty-focused treatment for patients.

📋 Description

• Reporting to the VP of Compliance, the Compliance Auditor is responsible for ongoing analysis and review of coding accuracy, medical necessity documentation, and regulatory compliance in patient records • Conduct compliance focused monitoring and audits related to coding accuracy, medical necessity, supporting documentation and other operational functions • Conducts ad hoc reviews and audits based on high risk, problem prone, or otherwise specified areas • Maintains tools, reports, data, metrics, benchmarking, tracking, and trending patient and compliance data • Participates in various committees to address risks and opportunities for improvement, to report on compliance data, and collaborate in process improvement initiatives • Provide reports to management on compliance metrics and audit findings as requested

🎯 Requirements

• RN or LPN required • Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) strongly preferred • A minimum of three to five years experience in Medicare, Medicare Advantage, and/or Commercial Payers preferred • Strong knowledge of Florida statues, Medicare & Medicaid conditions of participation and payment, and commercial payer guidelines preferred