Senior Physician Compliance Auditor - Fully Remote - New York
Company: Catholic Health
Location: New York
Posted on: May 16, 2022
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Job Description:
At Catholic Health, we are more than 18,000 professionals
inspired by innovation, strengthened by compassion, and driven to
excellence. From working with a team of world-class healthcare
professionals to state-of-the-art facilities, you'll have
everything you need to do something incrediblefor yourself, and for
the community we serve. Join our team and discover why Catholic
Health was named Long Island's Top Workplace. The Senior Physician
Compliance Auditor shall be primarily concerned with performing
reviews to determine the accuracy of inpatient and outpatient
physician coding for Catholic Health Services of Long Island and
its System Affiliates (collectively CHS). Fully remote Long Island
based position Responsibilities: Understand and maintain strict
professional confidentiality of patient information, work plans and
projects. Maintain abreast of compliance issues related to the
healthcare industry, annual coding updates and frequent regulatory
changes. Exercise due professional care in performing compliance
reviews. Possess the knowledge, skills and disciplines essential to
the performance of compliance reviews. Coordinate and perform
educational training programs consisting of appropriate
documentation guidelines and accurate coding to all appropriate
personnel, including coding staff, physicians, billing personnel
and ancillary departments. Conduct regular audits and coordinate
the monitoring of coding and documentation accuracy. When
necessary, assist in the implementation of corrective action plans,
such as educational programs, to prevent similar denials and
rejections from recurring. Determine the scope, objectives and
approach of each review to be performed. Prepare compliance review
plans with emphasis on clearly describing the various auditing
procedures to be used and the key points in the area to which they
will be applied. Collect, analyze, interpret and document
information to support audit findings. Prepare audit reports to
document area under review, procedures performed and conclusions
met. Perform oral presentations to all levels of management
throughout the review, discussing review objectives and approach,
deficiencies found (if any), and recommendations for improvement.
Appraise adequacy of management's response to recommendations cited
in oral and written reports. Provide individualized feedback and
information to providers as it relates to the compliance audits
being performed. Conduct annual audits as it relates to the Office
of the Inspector General (OIG) and Office of the Medicaid Inspector
General (OMIG) work plans to ensure adherence with Federal and
State guidelines. Perform annual review of physician charge tickets
to ensure compliance with annual coding updates. Report
noncompliance issues detected through auditing and monitoring,
nature of corrective action plans, and results of follow-up audits
to the compliance management team Serve as a resource for
department managers, staff, physicians and administration to obtain
information on accurate and ethical coding and documentation
standards, guidelines and regulatory requirements. Obtain access to
technologies and other resources which provide up to date releases
on changes in laws, rules and regulations. Provide research and
support for special projects within CHS. Requirements: Bachelor
degree preferred. A minimum of five years physician office, billing
or auditing experience may be substituted in lieu of a degree. CPC
or CCS-P certification required. Position requires six months of on
the-the job training is required to become familiar with
organizational policies and procedures. Shall possess the
knowledge, skills and disciplines essential to the performance of
physician compliance reviews of healthcare institutions, as
follows: A strong knowledge base in complete and accurate clinical
documentation. A strong knowledge of Federal and State health care
regulations, standards, policies and requirements pertaining to
documentation, coding and billing. The ability to accurately
interpret and implement regulatory standards and legal
requirements. Strong analytical and problem-solving skills and have
expertise in report writing and oral communications. Strong
professional attitude and have the ability to work with and
communicate effectively with all levels of management and
personnel. At Catholic Health your well-being comes first, with
comprehensive compensation and benefits; our offerings go beyond
the basics. In addition to multiple medical plans, life insurance,
generous paid time off and flexible spending accounts, we also
offer substantial tuition reimbursement, an employer funded pension
plan and several savings plan options for your future.
Keywords: Catholic Health, New York , Senior Physician Compliance Auditor - Fully Remote - New York, Healthcare , New York, New York
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