The Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, and charges to ensure compliance with applicable documentation, coding, and billing requirements.
Works closely with, educates, and trains providers and staff on results, identifies issues and/or risks associated with documentation, coding and billing.
Job Duties and Responsibilities: Performs physician compliance audits to ensure accurate documentation and coding practices are maintained.
Identifies areas of risk and/or non-compliance and provides recommendations for action.
Conducts education and training sessions with individual providers on results, regulatory requirements and provide meaningful feedback for improvement.
Tracks, records, and maintains audit/review activity Provides consistent and ad hoc reporting Assists with audit & compliance related special projects as requested.
Education:High school diploma and GED required.
License/Certificate:Must be certified in one of the following: Certified Professional Coder (CPC), Certified Professional Coder Apprentice (CPC-A) or (CCS-P).
Work Experience:Two (2) years of professional fee coding/auditing experience (preferably in an academic medical setting).
Working Title: Physician Compliance Auditor
– PBS Compliance Department: MNS PBS Compliance Business Entity: Medical Network City: Los Angeles Job Category: Family & Function, Medical Network Job Specialty: Clinical Operations Position Type: Full-time Shift Length: 8 hour shift Shift Type: Day