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Auditor and Compliance Consultant Job in Harrisburg, Pennsylvania

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Job Title: Auditor and Compliance Consultant

Employer:LW Consulting, Inc
Type:Salaried Full-Time
Skills:Operational assessments,coding,auditing,compliance,documentation,appeals,training,Consulting experience a plus.
Specialties:Outpatient, Inpatient, Urgent care, OB/GYN, Internal Medicine, Hospitalist, Orthopedic, Emergency Services, Anesthesia, Pain, Clinical Lab, Radiology, Cardiovascular, Oncology, compliance, payer contracting matters, client operations, revenue integrity analyses
Required Certifications:CRC,or CCS-P,CPC-P
Preferred Certifications:,CCS,CCDS,RHIA,CPC-H,CPMA,RN,RHIT,PA,CDIP
Required Experience:5 to 7 years
Preferred Experience:5 to 7 years
Location:Harrisburg, PA
Date Posted:4/15/2019

Who We Are:

LW Consulting, Inc. (“LWCI”) is a fast-growing consulting company. The company provides management, consulting and strategic advisory services to the healthcare, government and technology industries.  The Auditor and Compliance Consultant is typically the lead consultant on client project teams, provides consulting to our clients and may serve as the project manager on engagements.   To learn more about us, please visit us at https://www.lw-consult.com/

 About the Role:

This position may be located in the Harrisburg office, or remote in the Eastern Standard Timezone.  

The Auditor and Compliance Consultant is responsible for delivering appropriate, well-supported, and thoroughly-documented decisions which may result in the identification of improper payments (overpayments and underpayments) on paid claims, or an opportunity to enhance revenue based on appropriate documentation. The consultant will independently research and provide citations for medical necessity, documentation, coding and billing determinations and will provide written substantiation for appeals, including options for curing or improving compliance.

The consultant must be comfortable in teaching and presenting in front of large and small groups including in front of professional associations.  The consultant will be responsible for leading training for new providers, annual education to physicians, and other education programs in person as well as by webinar.

Areas of consulting focus vary from project to project, but many client engagements focus on Outpatient and Inpatient services such as:  Urgent Care, OB/GYN, Internal Medicine, Hospitalist, Orthopedic, Emergency Services, Anesthesia, Pain, Clinical Lab, Radiology, Cardiovascular, Oncology and other Outpatient services.  Additionally, the Auditor and Compliance Consultant may be assigned projects which focus on: payer contracting matters, various regulatory compliance issues, client operations, the financial impact of coding and billing issues, and revenue integrity analyses.

Core duties and responsibilities include the following.  Other duties may be assigned.

  • Conducts operational assessments and coding.
  • Documents and bills audits and appeals of various medical specialties on a case by case and client-directed basis.  During such reviews, the Auditor and Compliance Consultant will assess ICD-9 / ICD-10 and CPT / ASA and E&M coding and billing to ensure accuracy and appropriateness, as well as compliance with government regulations (professional and facility).
  • Lead training for new providers, annual education to physicians, and other education programs in person as well as by webinar.

 Education and Experience:

  • Associate degree in Medical Coding
  • Bachelor’s Degree is preferred
  • 5+ years of relevant work experience in as a Medical Coder
  • Certified Professional Coder (Physician) - CPC-P OR Certified Coding Specialist - CCS-P, OR Certified Risk Adjustment Coder (CRC) are highly preferred
  • Experienced in working remotely
  • Consulting experience a plus

Required Abilities and Skills:

  • Strong interpersonal, verbal, and written communication skills
  • Ability to work independently and as a member of a team
  • Ability to work via telephone with remote team
  • Flexibility to work in a changing environment
  • Strong Microsoft Office skills, strong computer skills
  • Ability to thrive in a fast-paced environment
  • Promoting a positive Company culture, atmosphere and “team-player” attitude
  • Quickly gain knowledge of LWCI Company Goals, Standards, Policies and Procedures

 Company Offers:

  • Salary will be commensurate with experience and education
  • Comprehensive benefits package available including:  Healthcare Insurance, Paid Vacation & Holidays, 401k, Profit Incentive Plan, and Growth Opportunities

Applying


Send updated resume and cover letter to:

Sue Asten at sasten@lw-consult.com

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