Compliance Auditor (Coding Certified) Hybrid

Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady!SUMMARYAs a member of the Compliance team, the Compliance Auditor is responsible for leading and conducting key activities of Grady Health System's audit program. The Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Compliance Director and the Chief Compliance Officer. This position requires effective communication with internal stakeholders and external auditors. The candidate should possess excellent organization skills to ensure accuracy and timeliness of audit results.QUALIFICATIONSExperience conducting independent audits to assess risk with regulatory standards and writing formal reportsMinimum of five (5) years' experience in an acute care inpatient and/or outpatient settingsExperience conducting medical coding, medical necessity, claims denial, bundling, and reimbursement auditsWorking knowledge in the assignment of ICD-9-CM, ICD-10-CM, CPT, HCPCS and MS-DRG/APC classifications and reimbursement methodologiesStrong verbal and written communication skillsStrong analytical and critical thinking skillsAbility to work independentlyAbility to handle multiple priorities and deadlinesEDUCATIONAssociate's degree in Business, Healthcare, Nursing (ASN) or other related field requiredBachelor's Degree in Business, Healthcare, Nursing preferredBachelor of Science in Nursing (BSN) preferredMaster of Science in Nursing (MSN) preferredCERTIFICATES, LICENSES, REGISTRATIONOne of the following coding certifications through American Health Information Management Association or the American Academy of Professional Coders required:Certified Coding Specialist (CCS)Certified Coding Specialist - Physician (CCS-P)Certified Professional Coder (CPC, formerly CPC-H)Certified Outpatient Coding (COC)Certification in Health Care Compliance (CHC) preferredRegistered Health Information Technician (RHIT) preferredRegistered Health Information Administrator (RHIA) preferredCertified Internal Auditor (CIA) preferredCertified Health Care Compliance (CHC) preferredCertified Healthcare Auditor (CHA)Certified Healthcare Internal Audit Professional (CHIAP) preferredMeet annual requirements to maintain certification, license and registrationsCOMPUTER SKILLS:Strong working knowledge in Microsoft Word, Excel, Power Point and Outlook requiredExperience with electronic medical records and billing platformsAbility to learn new systems quicklyEqual Opportunity Employer-Minorities/Females/Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity.

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