Associate, Healthcare Compliance Auditor – Healthcare Transaction Strategy

Job Description: • Support client engagements and discrete segments of larger projects; • Research healthcare program requirements and payer guidelines; • Develop coding and documentation audit methodology using knowledge of key risk areas in coding and documentation compliance; • Perform coding and documentation audits, reviewing medical records and charges to ensure compliance with CPT-4/HCPCS and ICD-10-CM coding guidelines and standards, as well as the Centers for Medicare & Medicaid Services (CMS) coverage guidelines; • Conduct analysis of audit findings to identify trends/problems in coding and documentation and effectively communicate the audit findings and recommended areas for improvement to senior members of the team; • Monitor relevant resources, publications, and current government compliance and enforcement activity related to high-risk compliance areas; • Stay current on coding guidelines. Develop analyses using transactional data and/or financial data; • Make valuable contributions to client deliverables; • Demonstrate creativity and efficient use of relevant software tools and analytical methods to develop solutions; • Participate in group practice meetings; • Prioritize assignments and responsibilities to meet goals and deadlines. Requirements: • An undergraduate degree in a major relevant to healthcare (Public Health, Healthcare Administration, etc.) • An active coding certification (may be in apprentice status) or willingness to obtain a coding certification from either AAPC or AHIMA within 6 months of hire • An interest in medical auditing • 0-2 years of work experience that demonstrates a strong interest in the healthcare industry • Internships, fellowships, or work experience in a hospital or healthcare system preferred • Preference will be given to candidates who possess some knowledge of Medicare rules, regulations, and guidelines as they apply to coverage, coding, and provider documentation • Some knowledge of CPT-4, HCPCS, and ICD-10-CM coding systems, guidelines, and regulatory requirements is preferred • Proficient user in Microsoft Office Suite, specifically Excel, PowerPoint, Access, and Word Benefits: • Health insurance • Paid time off • Professional development Apply Now Apply Now