As a Compliance Auditor with YRMC you will perform proactive and reactive internal and external audits and investigations for hospital and outpatient services, rendered to ensure proper documentation, medical necessity, and accurate coding and billing are supported. The Compliance Auditor will monitor standards and regulatory guidelines in billing and coding, keeping internal staff abreast of these guidelines and conducting appropriate compliance training and education with the physicians and staff.

Summary:

Performs proactive and reactive internal and external audits and investigations for hospital and outpatient services rendered to ensure proper documentation, medical necessity, accurate coding and billing are supported.

Continually monitors regulations, standards and regulatory guidelines in coding and billing.

Conducts appropriate compliance training and education for physicians and staff (by request or as needed) using PowerPoint Presentations and Quick Reference Guides for ease of understanding and time management.

Conducts research for policies and department questions in billing, coding, regulatory and clinical indicators when requested which may include telephone calls, online research and/or in person contacts.

Completes reports as needed for Compliance, or other departments for the Board.

Support the Compliance Officer where and when needed in all areas of Compliance.

Attends Compliance Committee and other meetings as assigned.

Other duties as assigned.

Minimum Requirements:

Two (2) years or more related experience

Education:

Bachelors Degree in Health Care Administration

CPC (American Academy of Professional Coders)

Work Schedule: 8-hours, Days, Monday through Friday

Physical Requirements and working conditions for this position will be provided to you upon interview.