Senior Coding Compliance Auditor – Inpatient

🔥 4 minutes ago

🇺🇸 United States – Remote

💵 $76.3k - $131.6k / year

⏰ Full Time

🟠 Senior

🔎 Auditor

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Ensemble Health Partners

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

💼 Consulting

🛡️ Insurance

📦 Logistics

💰 Private Equity Round on 2022-03

Consulting • Insurance • Logistics

Ensemble Health Partners is a leading provider of revenue cycle management (RCM) services for healthcare organizations. They offer an end-to-end RCM solution that helps hospitals, health systems, and affiliated physician groups optimize their revenue cycles, reduce denials and underpayments, and enhance patient experiences using a combination of expert management and advanced technology. Ensemble Health Partners leverages certified operators and AI to deliver consistent results, improve collections, and support future growth for healthcare providers. They are recognized for their robust client partnerships and commitment to delivering reliable revenue lift and cost savings for their clients.

📋 Description

• Assist with development and execution of the Annual Compliance Workplan, including Auditing and Monitoring Workplans • Lead and complete detailed coding compliance audits, including complex audits • Implement Management Action Plans and prepare high-quality audit reports • Establish and maintain an Audit the Auditor Quality program • Coach and mentor new and existing coding auditors • Analyze audit findings to identify discrepancies, trends, patterns, and potential non-compliance • Develop actionable recommendations to mitigate compliance risks • Partner with service line leaders to develop and validate Management Action Plans • Provide regular audit and MAP updates to Compliance leadership and escalate urgent compliance concerns • Create and maintain audit process training materials and provide auditor training and ongoing support • Serve as a resource for Coding leaders on compliance audit questions and concerns • Maintain coding guideline and industry-standard knowledge • Create and maintain compliance audit records, analytical reports, issue logs, and dashboards • Assist with onboarding compliance coding auditors and answer their questions and concerns • Assess the compliance audit program and identify process improvement opportunities • Maintain collaborative relationships with internal and external stakeholders • Assist with auditor work assignments and follow up on deliverables • Assist with annual risk assessment and work plan preparation • Evaluate internal and operational controls related to regulatory requirements and corporate integrity and compliance • Participate in compliance program effectiveness evaluations and other assigned projects

🎯 Requirements

• 5–7+ years of experience in healthcare, acute coding, Compliance, audits, or a related field • ICD-10, DRG, CPT, and HCPCS coding knowledge, including acute outpatient and inpatient experience • Knowledge of revenue cycle operations, compliance standards, and auditing standards • Knowledge of Epic, Cerner, and/or Meditech • Basic Word and Excel knowledge • Willingness and ability to travel long-distance or by air, not to exceed 10% travel • Openness to innovation, including AI • Candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require • Must have and keep current at least one of: CPC, CCS, RHIA, or RHIT certification; CCS preferred • CHC certification may be obtained at a designated time upon acceptance into the role • Bachelor’s degree or equivalent experience in Health Records Management/Medical Coding preferred • Must reside and be authorized to work within the United States

🏖️ Benefits

• Bonus incentives • Paid certifications • Tuition reimbursement • Comprehensive benefits package including healthcare, time off, retirement, and well-being programs • Professional certification relevant to the associate’s field • Quarterly and annual incentive programs • Career advancement opportunities • Work-life flexibility • Remote work arrangement • Professional development • Reasonable accommodations for qualified individuals with disabilities