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Senior Coding Compliance Auditor – Outpatient
Ensemble Health PartnersSenior Coding Compliance Auditor at Ensemble ensuring compliance in healthcare revenue cycles. Overseeing audits, mentoring auditors, and enhancing compliance standards remotely across the US.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in auditing and compliance within healthcare, with a strong focus on coding standards and practices. Proficient in leading audits, analyzing findings, and implementing management action plans to ensure compliance and improve processes.
Highest-signal resume keywords
ICD-10 Coding KnowledgeCompliance AuditingManagement Action Plans (MAPs)Certified in Healthcare Compliance (CHC)Epic, Cerner, and/or Meditech Knowledge
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Coding Compliance AuditsAudit Report PreparationAudit Management ToolsRevenue Cycle OperationsCPT Coding KnowledgeHCPCs Coding KnowledgeDRG Coding KnowledgeInpatient ExperienceOutpatient ExperienceData Analysis
Soft Skills
Coaching and MentoringCommunicationInquisitive MindsetOpenness to Innovation
Tools & Technologies
Audit Management ToolWordExcel
Certifications & Qualifications
Certified Professional Coder (CPC)Certified Coding Specialist (CCS)Registered Health Information Administrator (RHIA)Registered Health Information Technician (RHIT)
Industry Keywords
Healthcare ComplianceAuditing StandardsCoding GuidelinesCompliance StandardsAudit the Auditor Program
About the role
Key responsibilities & impact- Assist with the development and execution of the Annual Compliance Workplan including the Auditing and Monitoring Workplans
- Lead & complete detailed Coding compliance audits including complex audits
- Implement Management Action Plans
- Prepare high quality audit reports
- Establish and maintain an Audit the Auditor Quality program
- Coach and mentor new and existing Coding auditors
- Participate in other compliance program related activities
- Analyze audit findings to identify discrepancies, trends, patterns which may lead to potential non-compliance
- Create and maintain an Audit the Auditor program to monitor quality and identify opportunities for improvement related to audit management tools as well as audit processes
- Provide regular updates to the Compliance leader on audits, MAPs outcomes, and escalate potential compliance concerns which require immediate attention
- Create and maintain training material for Audit process and how to use the Audit Management tool/platform
- Communicate coding compliance concerns to Compliance leadership through identifying trends and patterns
- Keep up with coding guidelines and industry standards for coding practices
Requirements
What you’ll need- 5-7+ years of experience in healthcare, acute coding, Compliance, audits, or related field
- ICD-10, DRG, CPT & HCPCs coding knowledge to include Acute Outpatient and Inpatient experience
- Revenue cycle operations, Compliance standards, auditing standards knowledge
- Epic, Cerner, and/or Meditech knowledge
- Basic Word & Excel knowledge
- Long-distance or air travel - not to exceed 10% travel
- Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences
- Required Certifications: CHC (Certified in Healthcare Compliance)
- Candidates must have and keep current at least one of the following professional certifications (CCS preferred): CPC (Certified Professional Coder) CCS (Certified Coding Specialist) RHIA (Registered Health Information Administrator) RHIT (Registered Health Information Technician)
Benefits
Comp & perks- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement