Compliance Audit Coordinator

Job description

Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care. It takes a special person to work for Kaweah Health. We serve a region where the needs are great, which makes the rewards even greater. Every day, we care for people facing unique challenges and in need of healing. Throughout it all, our focus is to make a difference, and we do — in the health of our patients, our loved ones, and our community. Benefits Eligible Full-Time Benefit Eligible Work Shift Day - 8 Hour or less Shift (United States of America) Department 8895 Compliance Program Responsible for comprehensive compliance audit services for inpatient and outpatient locations, including risk assessments, compliance workplan development, audit planning and performance, and report presentation and education. QUALIFICATIONS License/Certification Required: AAPC Coding Certification CPC Preferred: Health Care Compliance Association CHC; AAPC Coding Certification CPB, COC, CIC Education Required: Bachelor’s degree in relevant field (Healthcare, Finance, Business) or equivalent experience Preferred: Master’s degree in relevant field (Healthcare, Finance, Business) or equivalent experience Experience Required: Five years in healthcare, three years in coding and auditing Preferred: Five years in healthcare leadership Knowledge/Skills/Abilities: Proven experience as a healthcare compliance auditor Experience in healthcare environment Knowledge of legal and regulatory requirements related to healthcare organizations, including Medicare and Medi-Cal billing requirements Excellent communication and collaboration skills JOB RESPONSIBILITIES With the support of the Director of Corporate Compliance, plans and performs compliance audits to evaluate compliance with laws, regulations, and organizational policies and procedures. Reviews and analyzes medical records and billing documentation to evaluate accuracy with coding and billing guidelines. Drafts and presents detailed audit reports to the Director of Corporate Compliance, relevant stakeholders and organizational leaders. Identifies compliance issues and develop action plans designed to prevent and resolve identified issues. Works with stakeholders to ensure corrective actions are taken in response to identified compliance issues. Assists in the development of compliance policies, procedures, and processes. Supports the development of the Annual Compliance Risk Assessment and Compliance Plan, including the development of written questionnaires and performance of interviews with relevant stakeholders and leaders throughout the organization. Assists external auditors as needed in their performance of compliance, coding, billing, financial, and/or regulatory audits overseen and/or coordinated through the Compliance Department. Participates as an active member of designated Committees, and reports on findings and completes special projects, tasks, and reviews assigned by the Committee and the Director of Corporate Compliance. Demonstrates the knowledge and skills necessary to provide care and services appropriate to the population served on the assigned unit or work area. Performs other duties as assigned. Pay Range $33.27 -$49.90 If you want to use your talents alongside people who face each day with courage and purpose, in an environment that empowers you to do your absolute best, this is where you belong.