Senior Compliance Auditor

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟠 Senior

🔎 Auditor

👻 Ghost score 10%

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US Anesthesia Partners

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 2012

💼 Consulting

🏥 Healthcare

⚕️ Healthcare Insurance

Consulting • Healthcare • Healthcare Insurance

US Anesthesia Partners is a leading provider of comprehensive anesthesia services, dedicated to delivering exceptional patient care and operational excellence. Founded by a team of forward-thinking anesthesiologists, USAP specializes in various anesthesiology areas including cardiovascular care, obstetrics, and pediatrics. With a network of thousands of clinicians and hundreds of facility partners across the nation, they serve over two million patients annually, aiming to redefine the standards of quality in anesthesia services.

📋 Description

• Lead and conduct continuous audits on scheduled, as-needed, or requested bases, focusing on anesthesia documentation, billing, and coding compliance. • Evaluate clinical documentation for compliance with coding, documentation, and billing laws, regulations, and guidelines. • Contribute to audit planning, identify potential risk areas, and communicate results to compliance leadership. • Review medical records to assess documentation, coding, and charge accuracy and identify variances. • Analyze, prepare, and present audit reports. • Develop and deliver targeted communications, training sessions, and educational programs for healthcare providers. • Communicate documentation, coding, and charge errors and trends to compliance leadership. • Support corrective action plans and coordinate remediation of audit findings and emerging risks. • Onboard and train new compliance auditors; mentor junior auditors and provide subject-matter expertise. • Prepare for external audits, coordinate information requests, and track deliverables. • Manage audit schedules and maintain accurate audit activity records. • Provide guidance on documentation, coding, claim review, and billing questions; monitor relevant laws, regulations, payer bulletins, periodicals, and websites. • Define audits, develop action plans, document findings, draft reports, and communicate results to compliance leadership and/or the Compliance Committee. • Participate in educational programs, training sessions, meetings, and special projects. • Maintain strict confidentiality of patient records and audit reports. • Perform other duties as assigned or requested.

🎯 Requirements

• High school diploma or equivalent is required; associate or bachelor’s degree in a related field is preferred. • 7+ years of anesthesia coding experience or an equivalent combination of education and coding experience. • Previous auditing experience required. • Certification in medical coding (Certified Professional Coder or Certified Coding Specialist) required. • Advanced certification as a Certified Anesthesia and Pain Management Coder (CANPC) preferred. • Certified Professional Medical Auditor (CPMA) or Certified Healthcare Auditor (CHA) preferred. • Expert knowledge of CPT, ASA, and ICD-10 coding. • Knowledge of managed care, Medicare, Medicaid, and workers’ compensation billing and coding rules, regulations, and guidance applicable to anesthesia. • Expert understanding of auditing methodologies and compliance frameworks. • Strong written and verbal communication skills, including high-level report writing. • Exceptional critical thinking, problem-solving, and data analysis skills. • Advanced research skills. • Strong time management, prioritization, and organizational skills. • Ability to independently investigate, analyze, and resolve complex or non-routine issues. • Proven ability to lead projects, mentor staff, collaborate with diverse departments, and communicate effectively with staff, providers, leadership, and stakeholders. • Working knowledge of computers and word-processing, spreadsheet, and database programs. • High attention to detail and accuracy. • Professional demeanor and ability to work effectively in cross-functional environments.