Compliance Billing Auditor

Company: Scp Health
Location: Dallas
Posted on: September 1, 2024

Job Description:

At SCP Health, what you do mattersAs part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.Why you will love working here:Strong track record of providing excellent work/life balanceComprehensive benefits package and competitive compensationCommitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.What youll be doing:The Compliance Auditor reports to the Compliance Manager and is responsible for auditing billing and coding processes to ensure compliance with Medicare and other governmental payor rules and regulations.Conducts regular baseline, focused, follow-up and representative sample billing and coding audits as outlined in the annual audit plan.Develops reports of audit findings for each audit performed and analyses and trends resultsWorks collaboratively with revenue cycle and coding departments to gather information needed for each audit.Provides recommended corrective action related to audit findings.Remains knowledgeable of all healthcare laws and regulations, including but not limited to Medicare, Medicaid and other governmental payor rules and regulations.Remains up to date on internal billing and coding policies and procedures and appropriately applies them when conducting relevant audits.Assists with the development of policies and procedures related to auditing.Contributes to Company-wide Risk Assessment process.Exhibits the Companys Core Values and complies with the Code of Conduct.Who/What we are looking for:Bachelor Degree Required1-2 years of experience in professional billing and coding.Audit experience a plusCPC/CCS preferredRN and or RHIA/RHIT a plusStrong understanding of revenue cycle processes, including denials, appeals, remittance notices and adjustments.Understanding and application of billing and coding edits and claim logicStrong analytical, research and problem-solving skills. Must be able to recognize areas of the Company impacted by laws and regulations.Strong knowledge base in complete and accurate clinical documentation.Strong knowledge of payor rules and Federal and State health care regulations.The ability to accurately interpret/implement regulatory standards and legal requirements.Strong verbal and written communication skills.Strong computer skills (excel, and handling large data sets) Ability to work independently and handle multiple tasks/projects at the same time.To learn more about SCP Health, please visit:www.scphealth.comJoin our social circle:Check out our LinkedIn PageLike us on FacebookFollow us on TwitterSCP Health is an Equal Opportunity Employer.INDJV#LI-AR1by Jobble

Keywords: Scp Health, Dallas , Compliance Billing Auditor, Accounting, Auditing , Dallas, Texas