Compliance Auditor RN - Compliance Full time: Monday-Friday - Compliance

Profile

Job Location:
Fayetteville, AR
Job Type:
Full Time
Department
: Compliance
Shift
: Monday - Friday
Job Posting:
Compliance Auditor (RN) - Compliance (Full time: Monday-Friday)
Employment Type:
Full Time
Location:
Washington Regional Medical Center - Fayetteville, AR
Department:
Compliance
Shift:
Monday - Friday
FTE:
Job Number:
JO-2201-45017
Date Posted:
1/6/2022
Categories:
Licensed Nurses
Washington Regional
Washington Regional Medical Center is our regions only locally governed, community-owned, not-for-profit healthcare system. Our system includes a 425-bed acute care hospital located in the heart of Fayetteville supported by our clinic system - including primary, specialty and urgent care operations - that span across Northwest Arkansas into Harrison and Eureka Springs. Being heavily supported and invested in our community makes Washington Regional a unique employer, encouraging staff to give back to the community in which we live and work and give back to each other.
Washington Regional Mission, Vision and Values prove to be a firm foundation and inspiration from which we fulfill our purpose.
Mission:
Washington Regional is committed to improving the health of people in communities we serve through compassionate, high quality care, prevention and wellness education.
Vision:
To be the leading healthcare system in Northwest Arkansas --- the best place to receive care and the best place to give care.
Values:
To treat others patients and their families, visitors, physicians, and each other as we would want to be treated.
Position Summary
The role of the Compliance Auditor reports to the Corporate Compliance Officer. This position is responsible for development, implementation, and completion of audits and any resulting remediation activity. This position is also responsible for research and communication of changes in state and federal regulations, specifically Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs), as well as audit coding and documentation activities to confirm adherence to applicable regulatory requirements. This position will spend 80% of time sitting while performing work in a standard office environment and 20% of time standing and/or walking while pushing, pulling, lifting and/or carrying up to 50 lbs.
Essential Job Responsibilities
Serve as the expert in coding guidelines, governmental reimbursement laws, and regulations
Work closely with key management personnel throughout the organization to improve coding, billing, and documentation compliance
Assist with compliance investigations and responses to government requests
Identify trends and propose changes to current policies and practices to support regulatory compliance
Develop and deliver educational materials to help clinical and coding staff maintain compliance with state and federal rules and regulations
Monitor government and other payer LCD/NCD policy changes and communicates those changes to relevant business partners
Develop and manage projects to implement new guidance as NCD/LCD changes dictate and report those to appropriate management personnel
Review additional documentation requests for multiple payers prior to release of information
Assist the Clinical Integrity auditors in performing governmental and private payer audit reviews and submit appeals
Qualifications
Education:
Bachelors degree in nursing or relevant field
Licensure and Certifications:
RN license and Current certification as a Certified Coding Specialist required.
Experience:
Minimum 3 years experience in a chart auditing/medical reviews, required.

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