Compliance Coding Auditor
Sentara Patient Accounting, United States
City/State
Norfolk, VAWork Shift
First (Days)Overview:
Sentara Health is seeking to hire a qualified individual to join our team as a Compliance Coding Auditor!Position Status: Full-time, Day Shift
Position Location: This is a remote position for residents of Virginia or North Carolina.
Position Summary:
Performs a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines. Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year. All queries arising from the audit process are managed by the Compliance Auditor. Follows audit plan, completing numerous audits and providing follow-up to coders, management, and physicians. Looks for new problem areas, trends, etc., and advises Manger of Audit and Coding Compliance. Works with leadership regarding scheduling of internal and external audits.
Required:
CPC or CCS
4+ years of experience with multi-specialty coding and acute care outpatient coding
Professional fee coding experience
Please visit the link below to learn more about Sentara’s commitment to diversity and inclusion:
https://www.sentara.com/aboutus/mission-vision-and-values/diversity.aspx
Sentara Overview
For more than a decade, Modern Healthcare magazine has ranked Sentara Health as one of the nation's top integrated healthcare systems. That's because we are dedicated to growth, innovation, and patient safety at more than 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals.
Sentara Benefits
As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers. We offer a variety of amenities to our employees, including, but not limited to:
- Medical, Dental, and Vision Insurance
- Paid Annual Leave, Sick Leave
- Flexible Spending Accounts
- Retirement funds with matching contribution
- Supplemental insurance policies, including legal, Life Insurance and AD&D among others
- Work Perks program including discounted movie and theme park tickets among other great deals
- Opportunities for further advancement within our organization
Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For information about our employee benefits, please visit: Benefits - Sentara (sentaracareers.com)
Join our team! We are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, and growth!
Please Note: The yearly Flu Vaccination is required for employment.
Note: Sentara Health offers employees comprehensive health care and retirement benefits designed with you and your family's well-being in mind. Our benefits packages are designed to change with you by meeting your needs now and anticipating what comes next. You have a variety of options for medical, dental and vision insurance, life insurance, disability, and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave. Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met.
We provide market-competitive compensation packages, inclusive of base pay, incentives, benefits, and equity. The base pay rate for Full Time employment is:$25.60 - $42.67Benefits: Caring For Your Family and Your Career• Medical, Dental, Vision plans• Adoption, Fertility and Surrogacy Reimbursement up to $10,000• Paid Time Off and Sick Leave• Paid Parental & Family Caregiver Leave • Emergency Backup Care• Long-Term, Short-Term Disability, and Critical Illness plans• Life Insurance• 401k/403B with Employer Match• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education• Student Debt Pay Down – $10,000• Reimbursement for certifications and free access to complete CEUs and professional development•Pet Insurance•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
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Alabama Delaware Florida Georgia Idaho Indiana Kansas Louisiana Maine Maryland Minnesota Nebraska Nevada New Hampshire North Carolina North Dakota Ohio Oklahoma Pennsylvania Remote Remote for Virginia or North Carolina residents Remote position South Carolina South Dakota Tennessee Texas Utah Virginia West Virginia Wisconsin Wyoming
Benefits/Perks401k/403b 401k/403b with employer match 403b Advancement opportunities Amenities Annual discretionary bonus Comprehensive Health Care Dental Dental Insurance Development Disability Emergency backup care Flexible Spending Flexible Spending Accounts Healthcare Life Insurance Medical Medical, dental, and vision insurance Medical Insurance Paid Annual Leave Paid leave Paid parental leave Paid Time Off Pet Insurance Quality healthcare Remote work Retirement benefits Retirement funds with matching Retirement matching Sick Leave Student debt pay down Supplemental Insurance Supplemental insurance policies Training Tuition Assistance Variety of amenities Vision Vision Insurance Vision plans Work perks Work perks program
Tasks- Advise on compliance
- Auditing
- Billing
- Coding
- Educate physicians and coders
- Manage audit queries
- Perform audits
Accounting Acute care Acute care outpatient coding Auditing Billing Coder education Coding Compliance Compliance coding CPT CPT coding Federal payer policies Healthcare Healthcare systems ICD coding IT Leadership Management Management of AR queries MPFS payment methodology Multi-specialty coding NPP services Outpatient coding PBB locations Physician education Reimbursement RVU Scheduling Support Training
Experience4 years
Education Certifications TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9