Southern Illinois Healthcare
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CLINICAL COMPLIANCE AUDITOR
2 months ago
(9/26/2019 2:31 PM)
Management & Professional
Weekends as required
Responsible for performing appraisal activities, including quality and compliance reviews of physician coding, documentation, and billing practices.
Role Specific Responsibilities
Plans and performs audits and investigations focused on detecting and preventing fraud and abuse and prepares written reports of findings and recommendations.
Provides feedback and education regarding audit findings.
Provides support for the development of corrective actions for deficiencies.
Responds to inquiries from patients, physicians and staff.
Conducts trend analysis.
Reviews requests from government agencies, payors and patients.
Conducts compliance education.
Produces periodic compliance newsletter for staff, including physicians.
Assists with external audits, investigations, and appeals.
Bachelor’s degree, RN, RHIT, or RHIA
Licenses and Certification
Professional coding certification or RHIT
Experience and Skills
Technical Experience: 3 years
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