Revenue Cycle Acute/Hospital Coding Compliance Auditor

**This position requires coding experience on the hospital/acute side. Inpatient or outpatient**

The Coding Compliance Auditor will be responsible for the timely and effective completion and documentation of compliance audits and control validation as identified by the Compliance workplan and other ad hoc activities. Based on audit outcomes, the auditor will assist departments in executing corrective actions.  This position requires working knowledge of revenue cycle operations, documentation requirements, & federal and state regulations pertaining to but not limited to federal healthcare program requirements, OIG program guidelines and workplan, coding, documentation, & billing requirements.

The Coding Compliance Auditor II will serve as SME/SMART and assist with escalations, ad Hoc audit request, & education and training of department new hires.

What You Will Do:

• Manage, coordinate, and complete compliance audits within allotted timeframes.
• Ensure management corrective actions and follow up items are completed according to agreed-upon deadlines.
• Create and maintain audit records, analytical reports, and track and trend audit program activities.
• Help evaluate the adequacy and effectiveness of internal and operational controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to corporate integrity and compliance,
• Effectively communicate compliance concerns to Compliance leadership and operational leaders to provide timely notification to business unit management of statutory, regulatory or policy change.
• Monitors regulatory, legal, and industry developments and identifies opportunities for their application to the Corporate Compliance program.
• Create and maintain cumulative compliance program activity records, analytical reports, and track and trend compliance program activities; manage compliance program issue logs and dashboards.
• Maintains accurate, complete, and up-to-date compliance documents and records and produce for Compliance leadership upon request
• Ability to be flexible, multitask, and switch priorities as well as work comfortably in a deadline driven/productivity environment.  
• Ability to prioritize, organize, plan, and implement services as well as handle multiple projects/problems simultaneously
• Contribute to the achievement of Compliance Department goals and objectives and adhere to departmental policies, procedures, and standards; comply with organizational policies and procedures, governmental laws and regulations and accreditation standards.
• Effectively maintain collaborative working relationships with all stakeholders including clients, Ensemble staff, and external entities representatives.
• Serve as subject matter expert in assigned areas within revenue cycle.
• Assist with answering questions, training, and education of new hires and with completing ad hoc audit requests and respond to escalations as assigned by direct supervisor.
• Assist with development and maintenance of training material and Standard operating procedures.
• Assist with work assignment of the auditors and follow up on deliverables to ensure deadlines are met.
• Conduct quality assurance audits of Compliance Auditor I.
• Participate in other projects as assigned and complete tasks within requested timeframes. Participates in periodic compliance program effectiveness evaluations.

Minimum Experience:

• Active Coding certification. (CPC, or CPMA etc.)
• Auditing and/or Compliance certifications are preferred
• Previous experience in a similar role
• Previous experience in coding/coding auditing

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