Compliance Auditor and Educator - ETSU Health : Job Details

SUMMARY:TheCompliance Auditor and Educator will participate in the performance of medicalrecord audits of all College of Medicine Departments involved with billing third-partypayers. Will also serve as an educator forphysicians, residents, and billing/coding staff regarding coding anddocumentation requirements.

ESSENTIAL DUTIES AND RESPONSIBILITIES: include the following. Other duties me be assigned.

• Perform annual audits of documentationof inpatient and office medical records by physicians, residents, nursepractitioners and other providers.
• Educate the physicians, residents, nursepractitioners and other providers of coding and documentation issues based onthe audits.
• Report audit results to the AssociateDean, Compliance Committee, and Board of Directors as appropriate.
• Provide coding and documentationguidelines to the physicians, residents, nurse practitioners, and billingemployees as needed.
• Provide an orientation to all new hirephysicians on the compliance plan and policies, teaching physician guidelines.
• Research problem areas and providesolutions related to coding and payer requirements.

EDUCATION AND/OR EXPERIENCE:Knowledge of CPT, ICD-10-CMand HCPCS coding systems and guidelines.Basic knowledge of HIPAA guidelines necessary. Experience in an academic and/or multi-specialtyenvironment. Knowledge of medicalterminology, physician billing, third-party regulations and auditingprocedures. High school diploma or GEDrequired. CPC or CCS required, plus 3 yearsof coding and billing experience. CPMAis preferred; this certification would be required to obtain within 6 months ofemployment. Bachelors degree and/or previous auditing experience preferred butnot required.

OTHER SKILLS AND ABILITIES:Working knowledge of computers, keyboards andprinters. Skill in composition,compiling, and preparing a variety of correspondence, documentation, reports,and other materials. Abilityto establish and maintain an effective working relationship with facultymembers, staff, patients and other third parties. Ability to concentrate under high demands andlisten effectively. Ability to organizetasks, work as a team member and independently with a variety of professionaldisciplines. Convey a professional andpositive image and attitude.