Compliance Coding Auditor
The Compliance Coding Auditor is responsible for the administration of the Sharp HealthCare's (SHC's) compliance audit program. The position provides oversight and maintenance of a high-quality, effective, best practices coding, billing, and reimbursement audit compliance program to prevent and detect violations of law and other misconduct. This role will help promote ethical practices and a commitment to compliance with applicable federal, California, and local laws, rules, regulations, and internal policies and procedures. The position plays a key role in oversight of Sharp HealthCare's (SHC) compliance audit function and maintaining Sharp HealthCare's view of coding, billing and reimbursement compliance audits.
Required Qualifications:
- 5 Years experience in acute care inpatient/outpatient coding or professional E/M coding in the following coding systems: ICD-10-CM/PCS, DRG, CPT& HCPCs, and/or E/M CPT.
Preferred Qualifications:
- Strong background in ICD-10-CM/PCS coding, DRG coding and CPT coding classification.
- Certified Clinical Documentation Specialist (CCDS) - Various-Employee provides certificate -PREFERRED
- Certified Health Care Compliance (CHC) - Compliance Certification Board -PREFERRED
Other Qualification Requirements:
- Bachelor's degree in Business, Healthcare Administration, or related field - required. In lieu of Bachelor's degree, Associate's degree and a minimum of 5 years experience in coding, billing and compliance may be considered.
- One of the following is required: AHIMA's Certified Coding Specialist (CCS), or Certified Documentation Improvement Practitioner (CDIP), or AAPC Certified Inpatient Hospital/Facility (CIC), or Certified Professional Coder (CPC) certification. Certified Clinical Documentation Improvement Practitioner or Specialist (CDIP or CCDS) is required within 1 year of hire. Department management is responsible for tracking and ensuring employee receive certification within specified timeframe.
Essential Functions:
- Coding ComplianceCompliance Coding and Billing Audits
- Policy and Procedure maintenance
- Professional development
- Unit support
Knowledge, Skills, and Abilities:
- Ability to perform independent research and factual analysis of coding and billing matters and create proposed solutions to root causes.
- Computer proficiency with Microsoft office applications is required.
- Ability to function within a fast-paced, dynamic, and growing environment.
- Excellent time management and problem solving skills.
- Must demonstrate analytical ability, motivation, initiative, and resourcefulness.
- Teamwork and flexibility required.
Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class.