Southern Illinois Healthcare

  • CLINICAL COMPLIANCE AUDITOR

    Posted Date 2 months ago(9/26/2019 2:31 PM)
    Requisition ID
    2019-4733
    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 appraisal activities, including quality and compliance reviews of physician coding, documentation, and billing practices. 

     

    Responsibilities

    • 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.

    Qualifications

    Education

    • 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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