Senior Compliance Auditor

Description:

At Scripps Health, you will experience the pride, support, and respect of an organization that has been repeatedly recognized as one of the nation’s Top 100 Places to Work.

You’ll be surrounded by people committed to making a difference in the lives of their patients and their teammates. So, if you’re open to change, go ahead and unlock your potential.

As a Senior Compliance Auditor your duties will require you to independently perform a variety of operational and regulatory related audit projects. Plans and conducts coding and claims audits of specialized services, as well as process reviews, the results of which are documented and communicated to key stakeholders, including Senior Leadership. Conduct root cause analysis by identify operational and documentation gaps based on complex coding and regulatory guidelines, and provide solutions for improvement and/or remediation. Researches, summarizes and communicates complex healthcare and coding requirements to key stakeholders to guide them through risk-identification and mitigation strategies. Evaluate internal control to validate complex regulatory, documentation and coding requirements are mitigated to support continued compliance. Utilize advanced coding and regulatory knowledge to analyze data, identify trends and outliers, and understand and evaluate operational and regulatory risks throughout the organization. Proposes internal controls to mitigate regulatory, coding, documentation, and claims risks for hospital and professional services. Present complex information in a concise, meaningful and impactful way via verbal and written communication.

This is a full time, benefit eligible position located in San Diego. 

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Required Education/Experience/Specialized Skills\:

• Minimum of 4 years' experience in health care environment in coding, revenue cycle, compliance, or regulatory environment.
• Ability to critically thinking about information received in order to identify root cause, gaps, risks, errors, etc.
• Experience managing and leading projects with superior interpersonal, verbal, and written communication skills.
• Ability to present complex information in a concise, meaningful, and impactful way via verbal and written communication.
• Strong organizational and analytical skills.
• Ability to solve problems while working with key stakeholders.
• Able to adapt, prioritize to meet deadlines.
• Proficient with Microsoft Office applications.

Required Certification/Registration\:

• CCS-P, CCS, CPC, CDIP, CCDS.

Preferred Education/Experience/Specialized Skills/Certification\:

• Bachelor's Degree.
• 7 years' of physician practice or hospital coding or coding auditing experience preferred.
• Demonstrate an understanding of health care regulatory compliance guidelines.
• Knowledge of Medicare coverage, conditions of participation, requirements a plus.