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BWPO Compliance Auditor Job in Boston, Massachusetts

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Job Title: BWPO Compliance Auditor

Employer:Brigham and Women’s Hospital
Type:Salaried Full-Time
Required Experience:5 to 7 years
Location:Boston, MA
Date Posted:6/27/2018

BWPO Compliance Auditor

Brigham and Women’s Hospital, Boston, MA

40 hours, days

 

This position will be responsible for review and analysis of coding and compliance activities directly related to reimbursement for professional services in the Department of Surgery. BWPO Compliance Auditor will perform audits of clinicians to ensure that documentation supports the service that was performed. This position will also be responsible for educating the clinicians on coding and compliance issues.

 

PRINCIPAL DUTIES AND RESPONSIBILITIES:

·       Responsible for preparing audits for each provider.  These audits will include benchmarking against national averages.

·       Responsible for follow-up audits, as needed.

·       Responsible for tracking coding issues by provider and providing necessary education to improve coding. 

·       Responsible for preparing reports and presenting findings to management.

·       Responsible for educating providers post-audit on coding and documentation regulations and requirements.

·       Responsible for reporting and resolving all billing issues discovered during provider audits.

·       Keep informed of third party regulations in billing/reimbursement and maintain files of coding publications.

·       Handle special projects as assigned.

·       Participate in continuing education programs to ensure that coding knowledge remains current.

·       Assist manager in reviewing external payer audits

·       Assist manager in performing all tasks related to coding and compliance.

·       Perform other duties as needed.

 

SKILLS/ABILITIES/COMPETENCIES REQUIRED:

·       Ability to present findings and discuss issues with providers confidently and effectively

·       Strong attention to detail

·       Ability to interact with all levels of staff

·       Strong interpersonal, analytical, and presentation skills

·       Strong written and oral communication skills

·       Strong organizational skills

·       Excellent problem-solving skills

·       In-depth understanding and knowledge of ICD-10-CM and CPT coding

·       Ability to work both independently and as part of a team

·       Ability to work under pressure, multi-task, and meet deadlines

·       Familiarity with common office equipment and computer software, including MS Office and Database software

 

QUALIFICATIONS:

 

LICENSES, CERTIFICATIONS, and/or REGISTRATIONS:

·       Required:  CPC

·       Preferred: CPMA and/or CEMC

EDUCATION:

·       Minimum Required: High school diploma or GED Certificate 

·       Some college or Associate's Degree, Doctoral Degree

 

Field of Study (if applicable):

·       Knowledge of CMS (Medicare and Medicaid) and other 3rd party payers' billing and documentation requirements is required

·       American Academy of Professional Coders (AAPC) CPMA or CEMC, strongly preferred

 

EXPERIENCE:

·       5+ years of experience in a healthcare setting including ICD-10-CM and CPT Coding experience is required

 

To apply, a complete job description and application can be found by going to:

https://partners.taleo.net/careersection/jobdetail.ftl?job=3057664&lang=en#.WzKI0O_5fFM.email

 

Brigham and Women’s Hospital (BWH) is an international leader in healthcare and the site of pioneering breakthroughs that have improved lives around the world. Whether measured in terms of lives saved, expanding the boundaries of medicine through research, serving the needs of our local and global community, transforming the future of healthcare through education, or the personal satisfaction of stretching your talents— a career at BWH is unlike any other. Here you will find teamwork and collaboration are the norm. Our employees form a close-knit bond, based on mutual respect and devotion to our patients which forms the basis for our workplace culture known as the Brigham way.

 

BWH offers competitive salaries and a generous benefits package, to learn more please visit our benefits overview web site page here: http://www.brighamandwomens.org/About_BWH/Careers/benefits.aspx

 

Brigham and Women's Hospital is an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, ancestry, age, veteran status, disability unrelated to job requirements, genetic information, military service, or other protected status.

Applying

To apply, a complete job description and application can be found by going to:

https://partners.taleo.net/careersection/jobdetail.ftl?job=3057664&lang=en#.WzKI0O_5fFM.email


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