Senior Compliance Auditor

**Remote opportunity in the following locations: VA, MD, WV, NC, SC, GA, FL, TN, KY, AR, AL, MI, OH, KS, MO, TX**

The Senior Compliance Auditor reviews complex audits, performs quality assurance reviews, acts as a peer mentor, and assists management with onboarding process of new auditors.

The Senior Compliance Auditor supports the audit manager with the development and maintenance of the quarterly audit work plan and audit workflow processes. The Senior Compliance Auditor recommends changes to improve business operations by using professional judgement and knowledge of best practices. This position contributes to special projects, as applicable. The Senior Compliance Auditor perform documentation/chart audits on inpatient and outpatient records, and to provide analysis of the records (provider and facility) reviewed, education and other assistance, as needed.

The Senior Compliance Auditor audits VCUHS coding and billing (DRG, CPT, ICD 10) based on a review of medical record documentation and/or billing claim data.

Licensure, Certification, or Registration Requirements for Hire: One (1) of the following current AAPC certifications: Certified Professional Coder (CPC) Certified Professional Coder–Hospital (CPC–H) Certified Professional Coder–Payer (CPC-P) CPMA Certified Professional Medical Auditor (CPMA) OR One (1) of the following current AHIMA current certifications: Certified Coding Associate (CCA) Certified Coding Specialist (CCS) Certified Coding Specialist–Physician Based (CCS-P) OR Other current coding related certification Licensure, Certification, or Registration Requirements for continued employment: One (1) of the following current AAPC certifications: Certified Professional Coder (CPC) Certified Professional Coder–Hospital (CPC–H) Certified Professional Coder–Payer (CPC-P) CPMA Certified Professional Medical Auditor (CPMA) OR One (1) of the following current AHIMA current certifications: Certified Coding Associate (CCA) Certified Coding Specialist (CCS) Certified Coding Specialist–Physician Based (CCS-P) OR Other current coding related certification Experience REQUIRED: Minimum of five (5) years of progressively responsible experience in a healthcare environment to include, but not limited to, the following: Working with electronic health records to analyze and interpret clinical documentation for compliance purposes Auditing and investigating medical records for compliance Understanding and identifying diagnostic and procedural codes for clinical services rendered Previous experience with personal computers and software applications to include Microsoft Word, Excel, PowerPoint, and data collection tools.  Previous analytical experience Experience PREFERRED Seven (7) years of progressive coding and/or coding review experience in CPT, ICD-10; HCPCS coding Five (5) years previous hospital/physician related work experience in training individuals or groups Education/training REQUIRED: Bachelor’s Degree in Business, Finance, Allied Health or other health related field from an accredited program Education/training PREFERRED: N/A Independent action(s) required: Utilizes high degree of self-direction by analyzing an issue, developing a plan to resolve, and implementing the resolution. Takes intitatives and performs tasks with minimal supervision. Supervisory responsibilities (if applicable): N/A Additional position requirements: N/A Age Specific groups served: All / Any Physical Requirements (includes use of assistance devices as appropriate): Physical Lifting less than 20 lbs. Activities: Prolonged sitting, Walking (distance), Reaching (overhead, extensive, repetitive) Mental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking Emotional: Fast pace environment, Steady pace, Able to handle multiple priorities, Able to adapt to frequent change

Remote/Hybrid

Days

EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.