Southern Illinois Healthcare

  • COMPLIANCE AUDITOR

    Posted Date 2 months ago(9/10/2019 12:24 PM)
    Requisition ID
    2019-4644
    Job Locations
    US-IL-Carbondale
    Category
    Management & Professional
    Position Type
    Full Time
    Shift
    8AM-4:30PM
    Weekend Requirement
    Weekends as required
    Department
    Compliance
  • Overview

    Responsible for performing independent quality and compliance reviews of coding, documentation, utilization and billing practices. Planning and performing compliance audits of moderate difficulty and complexity with minimal supervision. 

    Responsibilities

    Role Specific Responsibilities

    o Participates in development of the Annual Work Plan.
    o Provides support for answering the Compliance Helpline.
    o Researches regulatory issues.
    o Performs audits and investigations with focus on detecting and preventing fraud and abuse.
    o Develops project-specific audit plans.
    o Reports on audit findings, provides related education, and supports the development of corrective actions for deficiencies.

    Qualifications

    • Associate’s degree in Health Information with coding certification or Bachelor’s in a related field. 
    • Knowledge of healthcare reimbursement systems, insurance claims processing, hospital operations, regulatory interpretation, and auditing principles, techniques, and standards is required.
    • Experience with Microsoft Office applications is also required. 
    • Strength in a number of key areas including analytics, problem identification, investigation, communication (written and oral), and resolution skills. 
    • Three years of experience is required

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