[Hiring] Inpatient Coding Compliance Auditor @Memorial Healthcare

At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: The Compliance Auditor is responsible for implementing and promoting Memorial’s Compliance Audit Plan to assist the Director of Compliance in reviewing and in ensuring compliance with federal and state laws while affirming organizational commitment to honesty and integrity in all phases of corporate conduct and to assist executive management by performing compliance audits based on the Annual Compliance Work Plan and the special requests of the Chief Executive and other Administrative Officers. Responsibilities: Responds to formal inquiries to the Compliance Hotline to ensure compliance with all laws, regulations, stated policies and procedures. Responds to formal inquiries from other Departments within the System to ensure compliance with all laws, regulations, stated policies and procedures. Participates in investigations and responds to questions, issues, reports and formal inquiries by federal and state agencies of possible violations or non-compliance matters raised by employees, patients, physicians and the public. Assesses and, if necessary, investigates and responds to formal inquiries by federal and state agencies as well as matters of non-compliance raised by employees, patients, physicians and the public.The Compliance Auditor is responsible for conducting audits of the System’s compliance with laws and regulations established by the Centers of Medicare and Medicaid Services and the Agency for Health Care Administration. The Compliance Auditor is expected to examine and analyze patient medical records to confirm that documentation supports medical necessity, appropriateness of services provided, coding and the services charged and billed. Compliance Auditor assists in monitoring compliance with state and federal laws and the System's Policies and Procedures to identify deviations and recommend corrective action to the System's Chief Executive Officer. Audits are performed in accordance with accepted standards and reports all pertinent findings based on the outcome of the audit. Compliance Auditor prepares formal written audits reports for executive management that include audit methodology, findings of any deviations, inaccuracies or irregularities, and recommendations to correct identified non-compliance. Compliance Auditor provides the Chief Compliance and Internal Audit Officer with written reports of findings and recommendations on a timely basis. Compliance Auditor interacts with legal counsel to discuss the organization's initiatives on regulatory compliance. Compliance Auditor monitor audit recommendations and retest departments that were previously audited using a smaller sample of transactions to ensure that recommended changes have been implemented and are effective.Communicates with and educates employees on the Memorial Healthcare System (MHS) Compliance Program Assists in the providing employee training seminars in accordance with the Compliance Policy on Employee Training Policies and Procedures. Compliance Auditor achieves and maintains proficiency in federal and state regulations; attends seminars; compiles and analyzes laws, regulations and interpretive materials. Meets and participates in quarterly Compliance Working Committee to ensure that the compliance process is functioning as required. Competencies: ACCOUNTABILITY, ANALYSIS AND DECISION MAKING, CUSTOMER SERVICE, EFFECTIVE COMMUNICATION, HEALTHCARE INDUSTRY, MEASURING RESULTS, PROBLEM SOLVING, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR Education and Certification Requirements: Bachelors: Nursing (Required)Registered Nurse Compact License (RN LICENSE COMPACT) - Compact RN Multistate, Registered Nurse License (RN LICENSE) - State of Florida (FL) Additional Job Information: Complexity of Work: This role requires critical thinking skills, effective communication including public speaking and written communication skills, decisive judgment, and the ability to build and foster positive relationships. The incumbent must be able to lead others and take appropriate action when required. Knowledge of Federal, State and Managed Care rules and regulations, knowledge of legal principles. Must be team oriented and self-motivated. Must have basic computer skills such as word processing and spreadsheet abilities. Must have strong management, analytical, conflict resolution and group facilitation skills. Required Work Experience: Five (5) years experience in a regulated environment in positions of progressive responsibility. Two (2) years of auditing within a regulated environment. Working Conditions and Physical Requirements: • Bending and Stooping = 40% • Climbing = 40% • Keyboard Entry = 80% • Kneeling = 40% • Lifting/Carrying Patients 35 Pounds or Greater = 0% • Lifting or Carrying 0 - 25 lbs Non-Patient = 60% • Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 40% • Lifting or Carrying > 75 lbs Non-Patient = 0% • Pushing or Pulling 0 - 25 lbs Non-Patient = 60% • Pushing or Pulling 26 - 75 lbs Non-Patient = 40% • Pushing or Pulling > 75 lbs Non-Patient = 0% • Reaching = 60% • Repetitive Movement Foot/Leg = 0% • Repetitive Movement Hand/Arm = 80% • Running = 0% • Sitting = 80% • Squatting = 40% • Standing = 80% • Walking = 80% • Audible Speech = 80% • Hearing Acuity = 80% • Smelling Acuity = 0% • Taste Discrimination = 0% • Depth Perception = 60% • Distinguish Color = 0% • Seeing - Far = 80% • Seeing - Near = 80% • Bio hazardous Waste = 40% • Biological Hazards - Respiratory = 40% • Biological Hazards - Skin or Ingestion = 40% • Blood and/or Bodily Fluids = 40% • Communicable Diseases and/or Pathogens = 40% • Asbestos = 0% • Cytotoxic Chemicals = 0% • Dust = 60% • Gas/Vapors/Fumes = 40% • Hazardous Chemicals = 40% • Hazardous Medication = 0% • Latex = 60% • Computer Monitor = 80% • Domestic Animals = 0% • Extreme Heat/Cold = 40% • Fire Risk = 0% • Hazardous Noise = 0% • Heating Devices = 0% • Hypoxia = 0% • Laser/High Intensity Lights = 0% • Magnetic Fields = 0% • Moving Mechanical Parts = 60% • Needles/Sharp Objects = 40% • Potential Electric Shock = 40% • Potential for Physical Assault = 40% • Radiation = 0% • Sudden Decompression During Flights = 0% • Unprotected Heights = 0% • Wet or Slippery Surfaces = 0% Shift: Primarily for office workers - not eligible for shift differential Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification. Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process. Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity. Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law. We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program. Employment is subject to post offer, pre-placement assessment, including drug testing. If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email TalentAcquisitionCenter@mhs.net Apply tot his job Apply To this Job