Overview:
The Compliance Auditor is responsible for conducting provider documentation audits to assess compliance with documentation, coding, and billing guidelines as established by Medicare, Medicaid, Tricare, and other payers as appropriate. These guidelines may include, but are not limited to, inpatient and outpatient professional services, ancillary services (ex., labs, imaging), procedures (ex., injections, infusions, bariatric services), and ICD-10 diagnosis coding.
As part of these audits, the Auditor identifies trends that may pose risks to individual providers, as well as to Novant Health and its affiliates. The Auditor is responsible for creating summary documents detailing these risks and highlighting areas for overall documentation improvement. Additionally, the Auditor is responsible for educating providers and other involved team members on results of the audits, either through individual or group training sessions.
The Compliance Auditor is expected to maintain or exceed established quality and productivity standards set by Compliance leadership. This requires the ability to work independently, with minimum supervision.
The Compliance Auditor is also responsible for maintaining internal documents to support the Compliance audit function. These internal documents are used for tracking, trending, and reporting, and require timely data entries.
The Compliance Auditor may also be asked to complete additional tasks as assigned by Compliance leadership.

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At Novant Health, one of our core values is diversity and inclusion. By engaging the strengths and talents of each team member, we ensure a strong organization capable of providing remarkable healthcare to our patients, families and communities. Therefore, we invite applicants from all group dynamics to apply to our exciting career opportunities.

Qualifications:

• Education: Bachelor’s Degree, required. Master’s Degree, preferred.
• Experience: Minimum one year healthcare industry, preferred. Minimum one year healthcare coding, preferred
• Licensure/Certification/Registration: CPC, required. CRC, CHC, preferred. If no CRC certification, required within 12 months of hire, required.
• Additional Skills Required: The Compliance Auditor has:
• Limited to intermediate knowledge, skills, and abilities regarding internal controls, and understanding operations as they interface with the area of expertise;
• Limited to intermediate knowledge, skills, and abilities regarding clinical documentation, coding, and billing;
• Basic to intermediate knowledge, skills, and abilities regarding analytical skills, listening, and writing;
• Intermediate knowledge, skills, and abilities regarding presenting;
• Limited to advanced knowledge, skills, and abilities regarding researching regulations and standards, reimbursement protocols, and compliance program requirements; and Ability to drive/travel to multiple locations/facilities as needed.

Responsibilities:

It is the responsibility of every Novant Health team member to deliver the most remarkable patient experience in every dimension, every time.

• Our team members are part of an environment that fosters team work, team member engagement and community involvement.
• The successful team member has a commitment to leveraging diversity and inclusion in support of quality care.
• All Novant Health team members are responsible for fostering a safe patient environment driven by the principles of “First Do No Harm”.

Please refer the Job description for details