Job Description
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Healthcare Compliance Auditor position is a staff consulting position within the Healthcare Transactions and Strategy (HTS) group. HTS performs regulatory, reimbursement, data analytics, and compliance auditing for healthcare providers, healthcare payers, and healthcare investors. • Assessment of provider compliance programs • Auditing of billing and coding of clinical documents and claims documents • Execution of engagement work streams involving certified coding skills to audit provider claims and clinical documentation • Focus on government programs such as Medicare and Medicaid • Develop audit specifications and perform expert analysis of healthcare claims • Quality control and development of client deliverables The work of a Consultant involves: • Billing and coding audits • Compliance program review • Quality control • Development of client deliverables • Industry research The work of a Managing Consultant involves: • Management of junior staff • Quality control • Development and presentation of client deliverables • Industry research This specific position will require knowledge of medical coding and compliance, and potential candidates must have medical auditing expertise. Qualifications • An undergraduate degree (e.g., BS, BA) • Active coding certification from either AAPC or AHIMA is required • Preference for candidates certified in medical auditing • 2+ years of work experience with a focus on healthcare provider billing and coding; 5-7 years for Managing Consultant level • Experience with physician practice coding (e.g. primary care, dermatology, orthopedics, ophthalmology), ASC coding, and/or post-acute coding (e.g. hospice, home health, SNFs) • Comprehensive knowledge of Medicare rules, regulations, and guidelines • Advanced knowledge of CPT-4, HCPCS, and ICD-10-CM coding systems Requirements • Ability to interpret national coding and documentation guidelines • Proficient user in Microsoft Office Suite, specifically Excel, PowerPoint, Access, and Word • Commitment to producing high quality analysis and attention to detail • Excellent time management and organizational skills • Keen interest in healthcare compliance and healthcare policy • Exceptional verbal and written communication skills • Desire to work within a team environment • Must be able to submit verification of legal right to work in the U.S., without company sponsorship Benefits • Consultant Salary Range: $70,000 – $150,000 • Managing Consultant Salary Range: $100,000 – $230,000 Apply tot his job
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