Senior Coding Compliance Auditor – Outpatient

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Ensemble Health Partners

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

⚕️ Healthcare Insurance

☁️ SaaS

🏢 Enterprise

💰 Private Equity Round on 2022-03

Healthcare Insurance • SaaS • Enterprise

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 the development and execution of the Annual Compliance Workplan including the Auditing and Monitoring Workplans • Lead & complete detailed Coding compliance audits including complex audits • Implement Management Action Plans • Prepare high quality audit reports • Establish and maintain an Audit the Auditor Quality program • Coach and mentor new and existing Coding auditors • Participate in other compliance program related activities • Analyze audit findings to identify discrepancies, trends, patterns which may lead to potential non-compliance • Create and maintain an Audit the Auditor program to monitor quality and identify opportunities for improvement related to audit management tools as well as audit processes • Provide regular updates to the Compliance leader on audits, MAPs outcomes, and escalate potential compliance concerns which require immediate attention • Create and maintain training material for Audit process and how to use the Audit Management tool/platform • Communicate coding compliance concerns to Compliance leadership through identifying trends and patterns • Keep up with coding guidelines and industry standards for coding practices

🎯 Requirements

• 5-7+ years of experience in healthcare, acute coding, Compliance, audits, or related field • ICD-10, DRG, CPT & HCPCs coding knowledge to include Acute Outpatient and Inpatient experience • Revenue cycle operations, Compliance standards, auditing standards knowledge • Epic, Cerner, and/or Meditech knowledge • Basic Word & Excel knowledge • Long-distance or air travel - not to exceed 10% travel • Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences • Required Certifications: CHC (Certified in Healthcare Compliance) • Candidates must have and keep current at least one of the following professional certifications (CCS preferred): CPC (Certified Professional Coder) CCS (Certified Coding Specialist) RHIA (Registered Health Information Administrator) RHIT (Registered Health Information Technician)

🏖️ Benefits

• Bonus Incentives • Paid Certifications • Tuition Reimbursement • Comprehensive Benefits • Career Advancement