Senior Compliance Auditor

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Company: Samaritan Health Services

Location: Corvallis, OR 97330

Description:

  • This is a remote position in which we are able to employ in the following states: Alabama, Alaska, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin
  • JOB SUMMARY/PURPOSE
    • Supports the SHS Compliance Program in performing hospital and medical group-related audit activities to ensure compliance with federal health care program and state laws, regulations, standards, and guidelines.
  • DEPARTMENT DESCRIPTION
    • Provides oversight and direction for compliance with applicable federal/state rules and regulations and internal policies and procedures. This department is responsible for all lines of business in all service locations.
  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • Bachelor's degree in business, health, public health, administration, or a related field; or equivalent combination of education and experience required.
    • Five (5) years experience working in an auditing environment required.
    • Certified Coding Specialist (CCS), Certified Coding Specialist - Physician-based (CCS-P), or Certified Professional Coder (CPC) required.
    • Certified Healthcare Auditor (CHA), Certified Healthcare Internal Auditor (CHIAP), Certified Professional Medical Auditor (CPMA) preferred.
  • KNOWLEDGE/SKILLS/ABILITIES
    • Competency in reviewing and accurately verifying medical record documentation and compliance with medical coding and billing requirements. Extensive knowledge of CPT, HCPCS, APC, ICD10CM, ICD10PCS, and MSDRG.
    • Ability to effectively work with departments and leaders to address compliance audit-related findings and ensure completion of management action plans on a timely basis.
    • Ability to conduct research in response to compliance-related inquires and effectively communicate research results. Knowledgeable of continuously monitoring requirements of federal health care program and state laws, regulations, standards, and guidelines.
    • Ability to recognize, analyze and resolve issues. Ability to exercise analytical and critical thinking skills in risk assessment as well as planning, executing, and resolving audit activities for each faction of the health system.
    • Excellent customer service, written, and verbal communication skills. Ability to effectively communicate and disseminate information and updates to staff and leadership.
    • Skilled in utilizing computer applications, mainframe applications, and encoder systems. Familiar with Epic, MS applications, Word, Excel, PowerPoint.
  • PHYSICAL DEMANDS
    • Rarely
      (1 - 10% of the time)
      Occasionally
      (11 - 33% of the time)
      Frequently
      (34 - 66% of the time)
      Continually
      (67 - 100% of the time)
      CLIMB - STAIRS
      LIFT (Floor to Waist: 0"-36") 0-20 Lbs
      LIFT (Knee to chest: 24"-54") 0 - 20 Lbs
      LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
      CARRY 1-handed, 20 - 40 pounds
      BEND FORWARD at waist
      KNEEL (on knees)
      STAND
      WALK - LEVEL SURFACE
      ROTATE TRUNK Standing
      REACH - Upward
      PUSH (0-20 pounds force)
      PULL (0-20 pounds force)
      SIT
      CARRY 2-handed, 0 - 20 pounds
      ROTATE TRUNK Sitting
      REACH - Forward
      MANUAL DEXTERITY Hands/wrists
      FINGER DEXTERITY
      PINCH Fingers
      GRASP Hand/Fist
      None specified

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