医师编码合规审计员
Physician Coding Compliance Auditor
与以卓越著称的组织携手！Cedars-Sinai 连续19年获得国家研究公司（National Research Corporation）的消费者选择奖，表彰我们在洛杉矶提供最高质量的医疗服务。我们还获得了咨询公司（Advisory Board Company）的年度最佳工作场所奖。我们提供优秀的福利包，包括带薪假期、健康计划和403(b)退休账户。加入我们！了解为什么《美国新闻与世界报道》（U.S. News & World Report）将我们评为全美最佳医院之一。
你在该职位中的职责：
Physician Compliance Auditor 负责审查和审计索赔、医疗记录和费用，以确保符合相关的文档、编码和计费要求。与医务人员和员工密切合作，通过 Teams 或其他远程会议平台进行教育和培训或提供审计结果反馈。Physician Compliance Auditor 会识别与文档、编码和计费相关的风险和问题。该职位需要保持对编码和文档指南的专业知识和理解。与审计与合规经理及其他需要合规编码和文档专业知识的人员协作。在该职位中，你的职责包括：
- 通过分析医疗记录文档和编码服务，执行医生合规性审计和小组审计，以确保符合政府和组织的政策和程序。
- 识别风险和/或不合规领域，并提出改进建议——必要时推动实施。
- 为个别医生开展审计结果、法规要求的教育和培训，并提供可操作的改进建议。
- 汇总审计结果并呈报给医生、运营负责人和其他领导。
- 直接向医生反馈信息。
- 准备必要的报告，并将审计结果传达给管理层和临床医生。
- 准备培训和教育材料，作为专业领域专家。
- 在软件或 Excel 表格中跟踪、记录并维护审计/审查活动。
- 提供定期和临时报告。
- 根据要求协助审计和合规相关专项项目。
- 通过参加适当的研讨会和讲座，保持对医疗记录文档、编码以及政府法规合规性的高水平专业能力。
查看英文原文
Align with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company’s Workplace of the Year. We provide an outstanding benefit package that includes paid vacation, wellness initiatives and a 403(b). Join us! Discover why U.S. News & World Report has named us one of America’s Best Hospitals.
What you will be doing in this role:
The Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, and charges to ensure compliance with applicable documentation, coding, and billing requirements. Works closely with providers and staff to educate and train or provide audit results feedback through the use of Teams or other remote meeting platforms. The Physician Compliance Auditor identifies issues and/or risks associated with documentation, coding, and billing. This position is responsible for maintaining expert knowledge and understanding of coding and documentation guidelines. Collaboration with the Manager of Audit and Compliance and others where expertise in compliant coding and documentation is needed. In this role your duties will include:
- Performs physician compliance audits and group audits by analyzing medical record documentation and coding services to ensure compliance with government and organizational policies and procedures.
- Identifies areas of risk and/or non-compliance and provides recommendations for action - advances as needed.
- Conducts education and training sessions with individual providers on audit finding results, regulatory requirements and provide actionable feedback for improvement.
- Responsible for summarizing audits results and presenting to provider, operations leaders, and other leadership.
- Communicates feedback directly to providers.
- Prepares necessary reports and communicates audit results to management and clinicians.
- Prepares training and education materials acting as subject matter expert.
- Tracks, records, and maintains audit/review activity in software or excel spreadsheets.
- Provides regular and ad hoc reporting.
- Assists with audit & compliance related special projects as requested.
- Maintains a high level of competency related to medical record documentation, coding and compliance with government regulations by attending appropriate workshops and seminars.
- Monitors Medicare and regulatory agencies rules for updates and changes and supports Cedar-Sinai’s core values and procedures.
- Acts as a professional liaison for physician compliance related activities, in a professional and confidential manner.
Originally posted on Himalayas