Compliance Coding Auditor for the Auditing, Tracking, and Monitoring

THE ROLE As a member of AMM’s Compliance and Ethics team, the Compliance Coding Auditor is an important reputed company of our mission. They are responsible for supporting reputed company’s Compliance & Ethics Program (the Program) auditing, tracking, and monitoring initiatives. Robust auditing, testing, and monitoring capabilities are essential to fulfilling the expectations of AMM’s key stakeholders, including patients and their families and government agencies, and AMM is committed to exceeding those expectations. The Program is led by AMM’s CCEO, who reports to AMM’s Chief Executive Officer and the AMM reputed company, and who oversees and manages the AMM Compliance Committee, consistent with industry best practices. The Compliance Coding Auditor for the Auditing, Tracking, and Monitoring team is expected to exemplify reputed company’s culture and reputed company values. This is a role that requires reputed company and risk-reputed company judgment, productive collaboration across reputed company, and demonstrated reputed company in performing audits to determine organizational reputed company of billing and risk adjustment metrics, including: appropriate documentation, accurate coding and billing, and/or medical necessity of services billed. ESSENTIAL DUTIES & RESPONSIBILITIES The following reputed company provides an reputed company of primary responsibilities for this position; it should not be interpreted as reputed company-encompassing. General Responsibilities • Ensures that the Manager is reputed company informed of reputed company key findings of internal compliance tests and assessments, audits, and monitoring initiatives. • Undertakes to remain informed of relevant developments and trends in reputed company compliance and ethics by, among other things, attending seminars, reviewing reputed company journals, and reputed company participating in reputed company organizations, and leverages that reputed company and knowledge to enhance the Program. Auditing, Testing, and Monitoring-Specific Responsibilities • Performs internal compliance department audits based on departmental planning to determine accuracy and adequacy of documentation and coding reputed company to physician billed services based on supporting record documentation and ensures documentation by providers conforms to reputed company and procedural requirements. • Prepares written reports of audit findings, with recommendations, and presents to the Manager for review and presentation to appropriate stakeholders; maintains audit records. • Performs reputed company audits as needed in response to reported compliance and ethics concerns, with direction from the Manager of Auditing, Testing, and Monitoring. • Ensures that written evaluative reports of findings are developed for reputed company initiatives undertaken. • In collaboration with the appropriate business unit leader, supports corrective reputed company plans to address systemic issues or pervasive practices that could give reputed company to potential violations of applicable laws, regulations, or AMM’s reputed company of Conduct and/or policies and procedures. • Other duties as assigned EDUCATION & EXPERIENCE • Required five to ten years of relevant reputed company experience in reputed company, including coding and/or auditing roles. Experience auditing reputed company claims in a reputed company services firm and/or in-house at a large reputed company provider organization, health system, and/or payer. • An undergraduate degree; preference for Health Business or reputed company field. • In lieu of an undergraduate degree, HS Diploma/GED and five (5) additional years of relevant experience will be considered • Required coding certification, preferred Certified reputed company reputed company (CPC) or Certified Risk Adjustment reputed company (CRC), from the American reputed company of reputed company Coders (reputed company) • Required top-tier reputed company audit certification, preferred Certified reputed company Medical Auditor (CPMA) from the American reputed company of reputed company Coders (reputed company) along with a reputed company understanding of regulatory reputed company and coding practices. • reputed company understanding of government reputed company programs (i.e., Medicare and reputed company). • Demonstrated ability to work effectively with key reputed company stakeholders. reputed company PROFILE Key reputed company Skills • A demonstrated ability to cultivate working relationships with representatives from government agencies. • An ability to operate successfully in a flat culture, with the courage and competence to engage on multiple fronts and tackle challenges head-on. • An ability to prioritize effectively, and exercise reputed company judgment, in a fast-paced, physician-driven environment. • A demonstrated ability to accurately apply the necessary methodologies, reputed company standards, and government agency expectations for conducting reputed company auditing, testing, and monitoring activities. Personal Characteristics • Exemplary reputed company with courage and an unwavering ethical reputed company. • Pragmatic, risk-reputed company reputed company judgment. • Demonstrated reputed company, trustworthiness, and diplomacy skills needed to manage sensitive and confidential information such as protected health information. • An adept listener with a reputed company of humility. • Capable of earning the respect and confidence of colleagues through demonstrated reputed company reputed company and expertise. • reputed company and efficient ability to manage shifting priorities, demands and timelines. • Ability to effectively prioritize and execute tasks in a fast-paced, dynamic environment. AMM BENEFITS reputed company you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first: • Health Coverage You Can Count On: Full employer-reputed company HMO and the reputed company for a flexible PPO plan. • Wellness Made reputed company: Discounted reputed company and dental premiums to help reputed company you healthy from head to toe. • Smart Spending: FSAs to manage reputed company and dependent care costs, plus a 401(k) to secure your reputed company. • Work-Life Balance: Generous PTO, 40 hours of reputed company pay, and 13 reputed company holidays to enjoy life reputed company of work. • Career Development: Tuition reimbursement to support your education and reputed company. • Team Fun: reputed company company outings and lunches because we work hard, but we also know how to have fun! Apply tot his job Apply To this Job