2 certified coder auditing jobs found

This position has the primary function of coordinating and supporting the Deputy Chief Compliance Officer with administrative, analytical, and program coordination activities. This position will provide support related to compliance auditing activities and programs, assisting with developing and coordinating the Compliance Audit Plan, supporting proactive and reactive audits of professional fee billings in clinic and facility settings, including federally qualified health centers. Proactively support audit activities related to billing and coding risks to the SOM, identifying and calculating potential overpayments based on audit results, participating in the repayment process if necessary, reviewing research billing compliance issues and assisting the Deputy Chief Compliance Officer in designing and managing a comprehensive billing/auditing program.  The position supports compliance-related activities by gathering information, coordinating documentation reviews, monitoring...

Job Summary Designs and delivers education programs on compliant documentation, coding and billing practices, regulatory requirements, and internal policies through learning experiences such as instructor-led sessions, webinars, and e-learning modules. Serves as a key resource for physicians, clinical staff, auditors, coders, and other stakeholders, ensuring understanding and adherence to applicable standards. Analyzes data and reports to identify educational needs and may conduct limited audits to support targeted training efforts. Essential Functions: Develops and delivers targeted education based on new service or program implementation, CPT/ICD-10 changes, and regulatory changes. Reviews audit data and compliance trends to identify educational gaps and address areas of risk. Designs and maintains educational content and resources, supporting accurate CPT and diagnosis coding for professional services,...