Sinai Chicago

About Us: 

At Sinai Health System d/b/a Sinai Chicago, we take health care personally. Excellence in health care is about more than just medicine, technology, tests, and treatments, it is about really caring for people with dignity and respect. That is what we do. We are dedicated to providing the best care to meet the needs of people, for our community, for our patients and for you.

Position Purpose:

The Compliance Coding Auditor will report to the Chief Compliance Officer and will assist in maintaining

Compliance with CMS, OIG, and internal coding and billing compliance guidance as dictated by the SMG Coding and Billing Compliance Plan. This individual will be responsible for performing compliance audits on physician charts, provide an accounting of all audits and assess the controls in place to assure that audits are accurate and effective. This individual will also provide education to all new providers and administer yearly education to existing providers. While reporting to the Chief Compliance Officer, this position will maintain a close relationship with Revenue Cycle and the Health Information Management department including the coding team. Finally, this individual will serve on the All Payer Response team and will be responsible for reacting and responding to all government inquiries, requests, and audits.

Key Job Activities:

•       Assists in ensuring compliance with CMS, OIG, and internal coding and billing compliance guidance as dictated by the SMG Coding and Billing Compliance Plan.

o    Provides education to all new providers on best practices and work flow for coding and documentation.

o    Provides annual education and updates to all providers on newly emerging coding and documentation trends, changes to coding and documentation practices, and alerts all providers as necessary to the same.

o    Assists in educating new providers that have been identified by the revenue cycle/coding team as not in compliance with the expected error rate threshold or as having other coding and documentation issues as a result of the new provider coding hold.

o    Conducts a yearly 10 chart audit for all employed providers in compliance with the OIG guidance on this topic.

Education and Work Experience:

•       Bachelor’s degree

•       Eight plus years of experience with coding and/or billing in health care revenue cycle.  This should include hospital and physician practice.

Certifications/Licenses:

•       CPC required

•       Additional coding certifications preferred