Compliance Auditor

Profile

Compliance Auditor

Duties: The candidate will manage and delegate assignments/projects to team, instruct and monitor progress, trouble shoot and review projects for completeness and accuracy. Serve as a communications conduit between other areas of the division to the medical auditors. Collaborate with the VP of the division to mentor medical auditors, monitor projects and workflow processes to ensure compliance, accuracy and deadlines. Conceptualize the results of billing and coding audits/reviews performed by the audit team to help identify and explain patterns and trends. Explain findings in a clear, friendly and concise manner to internal team members and/or clients. Communicate in a way that demonstrates knowledge of regulations and requirements of CMS, payors, and Federal and state laws. Interact in a professional and courteous way with physician practices to help them locate missing documents and provide necessary chart information. Perform accurate and compliant auditing reviews of pertinent medical records and physician services to identify and report audit outcomes and need for coding education. Coding reviews include practice and ASC-based services, ensuring compliance with relevant CPT, HCPCS and Modifier guidelines, as well as ICD-10 CM, ICD-10.

Additional Information

Requisition Number: COMPL002306

Company info

McDermott Will & Emery
Three Embarcadero Center
San Francisco
California
United States 94111
Website : https://www.mwe.com