Compliance and Coding Auditor

Job Summary:  Assists with implementing and maintaining a system-wide effective compliance program through performance of compliance and coding quality audits. Under indirect supervision, assures appropriateness and accurate coding assignments in accordance with federal coding regulations and guidelines. Evaluates the effectiveness of internal controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to professional and facility fee documentation, coding and billing, including CMS and OIG compliance standards. Leads meetings with providers to review the audit findings and recommend ways to improve when indicated. Prepares written reports of findings. Also responsible for providing assistance with coding inquiries from providers, coders, billing staff, etc.  Monitors relevant resources and publications related to high-risk compliance areas. Serves as an audit software system administrator as assigned. Serves as a subject matter expert on interpretation and application of documentation and coding rules and regulations, and conduct enterprise risk assessments of potential and detected compliance deficiencies. Assists in the development of the Corporate Responsibility Annual Work Plan.