About the role

  • Medical Billing Compliance Auditor responsible for investigating compliance issues and performing audits in healthcare. Supporting compliance team initiatives while ensuring adherence to federal and state regulations.

Responsibilities

  • Under general supervision, ensures that compliance initiatives are met for all the NorthStar client sites.
  • Responsible for investigating potential compliance issues linked to clinical and billing activities.
  • Support the compliance team by performing quality, internal audits and monitoring essential services in compliance with federal and state laws and regulations.
  • Coordinates with Compliance Director and Chief Compliance Officer on any billing compliance investigations.
  • Reviews and audits documentation in the medical records and charges submitted including CPT and ICD-10 information to ensure compliance.
  • Reviews charge information, claim forms, and insurance correspondence to determine if coding, billing, claim follow-up, payment receipts, posting activities, and credit processing are being performed in an accurate and timely manner and is supported by documentation.
  • Analyzes billing trends to identify areas of non-compliance and prepares regular reports on audit findings to Compliance Director.
  • Collaborates with the Compliance Team to develop annual audit work plans.
  • Educates providers when deficiencies in documentation and code selection are identified.
  • Develops corrective action plans and participates in compliance investigations as needed.
  • Promote NorthStar Anesthesia’s Core Values.
  • Demonstrates regular, reliable and predictable attendance.
  • Performs other duties as required.

Requirements

  • 1 to 3 years applicable compliance experience, in healthcare industry preferred
  • CPC certification required
  • 4 years of healthcare billing and coding experience preferred.
  • Excel and Power Point knowledge preferred

Benefits

  • Competitive salary
  • Flexible work hours
  • Professional development budget
  • Home office setup allowance
  • Global team events

Job title

Medical Billing Compliance Auditor

Job type

Experience level

Junior

Salary

Not specified

Degree requirement

Professional Certificate

Location requirements

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