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Allstate
Sr Compliance RCM & Coding Auditor
CenterWell Senior Primary Care
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $86,300 - $118,700 per year
Job Level
Senior
About the role
- Assesses the compliance risks to PCO and leverages the assessment to design the auditing and monitoring activities included in the workplan
- Executes assigned portions of the PCO compliance workplan throughout the year
- Regularly conducts compliance-related audits to assess internal controls, examining healthcare records and processes, and analyzing and reporting risks
- Influences department strategy by identifying and overseeing the development of continuous monitoring activities
- Provides reporting on metrics and M&A activity related to revenue cycle management
- Coordinates site visits for regulators and implementation of corrective action plans
- Serves as regulatory compliance subject matter expert with the 2nd line of defense
- Researches compliance-related issues and communicates requirements to high-level business leaders within the PCO
Requirements
- Bachelor's degree
- 3 or more years of healthcare experience in revenue cycle management (related to billing, coding, collections for Medicare and Medicaid claims)
- Experience with Auditing and monitoring of healthcare records
- Must be able to work core business hours on EST time between (9am-5pm)
- Willingness to travel up to 10% to conduct audits at site locations
- Ability to manage multiple or competing priorities and meet deadlines
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
- Effective verbal and written communication skills
- Strong attention to detail
- Ability to articulate findings and impacts
- Knowledge/understanding of laws and regulations governed by the Department of Insurance and CMS
