Compliance Auditor

  • location: Lakeland, FL
  • type: Permanent
  • salary: $25 - $37 per hour
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job description

Compliance Auditor

Randstad USA is currently assisting our client in the searching for a Compliance Auditor. Our client is one of the largest clinics in central Florida and offers excellent career opportunities and room for advancement.

Conduct Medical Compliance Review of Clinic providers for inpatient and outpatient claims.

Responsibilities:
Determines the level of inservice education needed for providers.
Communicates credible and concise findings in provider reports.
Demonstrates a contribution to the department???s operation and goals/targets for the year.
Maintains monthly log of activity, Completes a minimum of 10 charts/quarter for assigned providers. Prioritizes workload maintains control over interruptions.
Pursues medical records needed from outside resources (i.e. SNF, other hospitals)
Identifies departmental process discrepancies during review process. Compiles monthly documentation of keying errors by provider, DOS, MRN and batch number. Reports any operational areas of risks identified. Reports treatment inconsistencies for review.
Adheres to guidelines set by the clinic???s Compliance Program and Audit policy and procedures
Reports clear and detailed recommendations to improve documentation of level of service billed specificity of ICD10 codes and RAF scores.
Conducts chart reviews of medical records for outpatient/inpatient providers. Reports on documentation to support CPT, ICD10, HCPCS and RAF reviews.
Identifies deficiencies and educational needs of provider.

Working hours: 8:00 AM - 5:00 PM

Skills:
Provides timely provider communication by memo and telephone.
Presents in a professional, organized and positive manner.
Demonstrates ability to use auditing software program, IDX system, LCD and local hospital resources to conduct reviews and summary of findings.
Ability to use the TES program in IDX for retrospective or concurrent reviews.

Education:
Trade

Experience:
Experienced

Qualifications:
Required Education and Experience:
High School diploma or equivalent and a minimum of 5 years coding/healthcare reimbursement experience.
Certification by American Academy of Professional Coders (CPC) for a minimum of 5 years or equivalent organization and CRC (Certified Risk Coder).
CRC certification must be obtained within 6 months.
Must have advanced knowledge in medical terminology and anatomy. Must have advanced knowledge of insurance reimbursement, principles and practice. Must have knowledge of computer and Microsoft Office.


This position is a direct hire opportunity, and we can get you in front of the hiring manager as soon as today! Ask me how. Well, I will tell you. It is simple. Click on the EASY APPLY button to submit your application and resume. We can set up a digital interview for you to complete at your convenience.
Keep in mind that time is of the essence, so apply TODAY!

If you meet the above qualifications and are interested, please click on the following Buttons:
Easy Apply, then select one of the three options (Apply Now, Apply with Indeed, or Apply with Monster)

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

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    Compliance Auditor

  • location: Lakeland, FL
  • job type: Permanent
  • salary: $25 - $37 per hour
  • date posted: 9/23/2019