Sr Compliance Auditor

Overview POSITION SUMMARY: The Sr Compliance Auditor is responsible for auditing the accuracy of assigned diagnostic and procedure codes to records of patients, ensuring compliance with federal, state, and regulatory requirements, payer requirements, and USAP policies and procedures, and providing accurate, meaningful, and timely audit reports and findings to management. This position is also responsible for communicating with management, and providers regarding audit results, new or revised documentation guidelines, and other compliance related information as required. Job Highlights ESSENTIAL DUTIES AND RESPONSIBILITIES : ( The ideal candidate must be able to complete all physical requirements of the job with or without a reasonable accommodation) Leads and conducts continuous audits on a pre-determined schedule, as well as on an as needed or requested basis, focusing on anesthesia documentation, billing, and coding compliance. Evaluates clinical documentation to validate compliance with coding, documentation, and billing laws, regulations, and guidelines to safeguard against fraud, waste, and abuse. Contributes to audit planning activities, identifies potential risks areas, and communicates results to compliance leadership. Prepares and reviews medical records to assess documentation, coding, and charge accuracy and identify variances. Analyzes, prepares, and presents audit reports. Develops and delivers targeted communications, training sessions, and educational programs