Auditor

• Provide patient focused, standardized, compliant revenue cycle support
• Assist Providence St Joseph Health in meeting financial objectives
• Thrive in a culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect

Revenue Cycle Auditor, RN

• Ensure SEARHC meets federal and state regulations and internal policies in regard to healthcare coding, documentation, and billing practices
• Review health records to verify coding and clinical documentation meets applicable coding and billing requirements, Medicare/Medicaid regulations, federal and state laws, and SEARHC policy
• Conduct Audits: Review health record documentation, claims, coding, policies and processes to identify compliance or non-compliance with SEARHC policies, state and federal laws and regulation, Medicare/Medicaid regulations, and national coding standards
• Analyze Data: Examine data to identify patterns and trends for compliance or non-compliance
• Identify Risk: Analyze audit results, data, policies, and processes to assess risk
• Develop Audit Plans: Create audits based on risk assessments, billing practices, new services, Medicare/Medicaid risk areas, Medicare/Medicaid audits, and RAC and PERM audits
• Prepare Reports: Document audit findings and recommendations
• Present reports to the Compliance Director, Chief Legal Officer, Division Vice President, Compliance Committee and Accreditation Governing Body
• Training and Education: Prepare and provide training and education to staff in response to audit findings, and staff inquiries
• Assist the Compliance Director as needed
• Work closely with legal counsel when interpreting billing laws and regulations
• Receive and investigate compliance and HIPAA complaints during absence of the Compliance Director.

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Revenue Cycle Auditor, RN

Compliance Auditor