Corporate Compliance & Privacy Auditor
Company: ChristianaCare
Location: Wilmington
Posted on: April 28, 2024
Job Description:
ChristianaCare is searching for a Corporate Compliance & Privacy
Auditor to join the team.This position will execute
moderate-to-complex level audits and participate in the evaluation
of the adequacy, effectiveness, and efficiency of internal controls
and identify weaknesses, along with providing recommendations to
mitigate those weaknesses. This position is required to be able to
work under limited supervision.Education and experience
requirements:At least one of the following degrees is required:
- Associates or Bachelor's degree in Nursing (active/unrestricted
license)
- Associate or Bachelor's degree in Health Information Management
(RHIA or RHIT)
- Equivalent experience of 5+ years' experience in provider
auditing, claims auditing, compliance auditing, quality assurance,
and/or recovery auditing
- Coding Certification (at least one of the following are
required and are to be maintained as a condition of
employment)
- Certified Professional Auditor (CPMA); Certified Professional
Coder (CPC); Certified); Certified Coding Specialist (CCS);
In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding
systems.
- Must be proficient in DRG/APC structure, National Correct
Coding Initiatives, ICD CM/PCS Official Guidelines, Outpatient
Prospective Payment System and Coding Clinic References. Current
working knowledge of encoder/grouper. Strong analytical and
communication skills.
- Candidates who hold a CCDS or CPC will be given consideration
but will need to obtain an inpatient coding certification within 1
year of their hire date with the company.
- Experience in auditing education techniques and methods
preferred, but not required.Principal duties and responsibilities:
- Review documentation to ensure appropriate assignment of DRG,
ICD-9 codes, CPT codes, and modifiers for facility-based and
provider-based clinical documentation, medical necessity, and/or
inpatient coding and has a high level of understanding in
reimbursement guidelines specifically an understanding of the
MS-DRG, AP-DRG and APR-DRG payment systems.
- Maintain a working knowledge of coding guidelines, HIPAA, and
CMS regulations.
- Participate in the planning and scheduling of compliance
projects.
- Work closely with providers to ensure accuracy in the coding
and documentation of service.
- Train new providers in coding and documentation
responsibilities.
- Research compliance related coding questions upon request from
departments and/or practices.
- Identify and report potential audit and compliance
risks.SPECIAL REQUIREMENTS:Must maintain current AAPC
certification.When you become an employee at ChristianaCare, you
are joining a robust healthcare organization that truly cares about
their patients and their caregivers. For the second consecutive
year, Forbes magazine has ranked ChristianaCare as one of the best
large health systems to work for in the United States! Guided by
excellence and love, our Caregivers enjoy a multitude of employee
benefits that include:
- Full Medical, Dental, Vision and other insurance benefits
- 403 (b) with an employer match
- Generous paid time off with annual roll-over and opportunities
to cash out
- 12 week paid parental leaveAbout Christiana
Care:veHeadquartered in Wilmington, Delaware, ChristianaCare is one
of the country's most dynamic health systems, centered on improving
health outcomes, making high-quality care more accessible and
lowering health care costs. ChristianaCare includes an extensive
network of outpatient services, home health care, medical aid
units, two hospitals (1,227 beds), a Level I trauma center and a
Level III neonatal intensive care unit, a comprehensive stroke
center and regional centers of excellence in heart and vascular
care, cancer care and women's health. ChristianaCare is a
not-for-profit teaching health system with more than 260 residents
and fellows. We are continually ranked by US News & World Report as
a Best Hospital. With our unique, data-powered care coordination
service and a focus on population health and value-based care,
ChristianaCare is shaping the future of health care.
Keywords: ChristianaCare, Wilmington , Corporate Compliance & Privacy Auditor, Accounting, Auditing , Wilmington, Delaware
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