The Enterprise Compliance Auditor/Educator supports the implementation and facilitation of ongoing compliance auditing, monitoring, and education across provider services within WVUHS and its affiliates.
This role helps ensure physician and non-physician provider organizations remain compliant with federal healthcare program rules, regulations, administrative requirements, and guidance. The position works closely with compliance leadership, departments, and provider groups to audit documentation, coding, billing, and medical necessity practices, and to educate staff on compliance and regulatory requirements.
Core responsibilities include audit planning and execution, review of medical records and billing documentation, development of audit reports and corrective action plans, delivery of presentations and training, support of compliance education initiatives, and participation in compliance committees and reporting activities.
Minimum Qualifications
- High school diploma or equivalent and 7 years of experience in multi-specialty coding, E&M coding, or procedural/surgical coding; or
- Associate degree and 5 years of experience in multi-specialty coding, E&M coding, or procedural/surgical coding
- Current certification in one of the following:
- CPC (AAPC)
- RHIT (AHIMA)
- CCS-P (AHIMA)
Preferred Qualifications
- Bachelor's degree
Skills and Knowledge
- Knowledge of provider healthcare compliance, revenue cycle operations, and auditing techniques
- Strong analytical and problem-solving skills
- Effective verbal and written communication skills
- Ability to work independently on complex assignments
- Proficiency with personal computers and financial application software
- Excellent organizational, time management, and presentation skills
- Ability to use electronic medical record and billing systems
- Ability to analyze complex EMR workflows related to documentation and billing
- Knowledge of governmental billing and coding regulations, including Teaching Physician Guidelines
Location
West Virginia, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
2 months ago