Compliance Auditor

Job not on LinkedIn

🔥 46 minutes ago

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $17 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

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Compass Health Network

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1972

🏥 Healthcare

🤝 Non-profit

🧘 Wellness

Healthcare • Non-profit • Wellness

Compass Health Network is a nonprofit community health organization based in Missouri that provides integrated, whole-person healthcare including behavioral health, substance use disorder treatment, pediatric and family medicine, dental services, crisis intervention, and wellbeing/recovery support. It operates certified community mental health services, 24/7 behavioral health crisis lines and crisis centers, youth urgent care, outreach and case management, and offers sliding-fee and Medicaid enrollment assistance to serve diverse, underserved communities.

📋 Description

• Audit service documentation for completeness, accuracy, and compliance with payer requirements • Use audit tool software to conduct audits, document findings, and support audit activities • Collaborate with internal audit staff on joint projects and identify opportunities to improve audit processes • Educate providers on audit findings and communicate results clearly, concisely, and accurately • Analyze anomalies identified through audit processes and escalate findings for further review • Apply program-specific regulatory requirements and dual-program audit procedures • Perform audit activities according to established efficiency standards and Audit Services leadership expectations • Meet with Compliance and Audit leadership to discuss findings, processes, priorities, and improvements • Evaluate clinical and operational changes' impact on audit processes and implement or recommend risk-mitigation actions • Participate in reviewing and resolving claim rejections and reimbursement discrepancies with Patient Accounting • Monitor documentation trends and report deficiencies and compliance concerns • Conduct follow-up clinical documentation improvement education based on audit findings • Review medical codes using ICD-10 and CPT to assess coding accuracy and compliance • Extract and analyze reports from electronic health record (EHR) systems for auditing, monitoring, and reporting • Perform other duties as assigned

🎯 Requirements

• High School/GED required • At least one (1) year of medical terminology preferred • Must have experience working collaboratively with diverse groups in a healthcare environment • Must be familiar with government healthcare reimbursement systems • Experience in ICD, DSM V, and Excel preferred • Detail-oriented and highly organized, with the ability to manage multiple priorities effectively • Ability to work independently and collaboratively to improve processes and outcomes • Ability to interpret data and identify patterns supporting compliance and operational improvement • Clear and professional communication with clinical and administrative teams • Commitment to accuracy, accountability, and continuous learning in a healthcare environment

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