SSM Health

Corporate Responsibility Auditor Senior

SSM Health

full-time

Posted on:

Origin:  • 🇺🇸 United States • Missouri

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Job Level

Senior

About the role

  • Initiates development and maintenance of compliance program, including compliance awareness education, implementation and maintenance of compliance policies and procedures, and monitoring of policy adherence and enforcement.
  • Identifies, researches, summarizes, presents, educates and implements traditional and non-traditional approaches to multi-faceted issues to provide best practice.
  • Performs or conducts compliance investigations and presents recommendations to physicians and committees.
  • Implements process improvements and supports system wide implementation of new initiatives.
  • Provides leadership and facilitates change in application of solutions requiring organized processes and outcomes.
  • Documents and discusses detected deficiencies in billing and reimbursement with personnel of departments and provides recommendations to prevent future deficiencies.
  • Develops and maintains processes to monitor program effectiveness through audits, analysis of employee hot-line reports, post office box inquires and other feedback mechanisms.
  • Remains current with government and third party billing regulations, government initiatives on fraud and abuse, and other related legislation.
  • Researches and performs analysis of compliance work plan.
  • Coordinates audits/record reviews and provides education to departments when necessary.
  • Implements corrective actions in cooperation with both clinic and business office management.
  • Serves as resource to all internal and external customers, answering questions, researching topics and providing information regarding coding, documentation and compliance issues.
  • Partners with other individuals/departments to foster best practice methodology and compliance.
  • Performs other duties as assigned.

Requirements

  • Bachelor's degree, or equivalent combination of experience and education
  • Three years' experience