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System Compliance Auditor
The University of Vermont Health Network. Identify and assess risks in documentation, coding and billing processes .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in auditing processes related to coding and billing, ensuring compliance with state and federal regulations. Capable of providing training and education to healthcare providers while identifying risk areas and recommending compliance measures.
Highest-signal resume keywords
Auditing ExperienceCoding And Billing KnowledgeRisk AssessmentCompliance StandardsAAPC Certification
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Risk IdentificationAudit ReportingBilling Process AnalysisRegulatory ComplianceTraining DevelopmentDocumentation ReviewProvider EducationAnnual Audit ExecutionRecommendation ImplementationCompliance Audit Work Plan Development
Soft Skills
CollaborationCommunicationProblem-SolvingLeadership
Certifications & Qualifications
AAPC CertificationCPC-E/M Auditor Certification
Industry Keywords
Healthcare OperationsFederal PayersBilling DepartmentsHealth Information ManagementRevenue IntegrityState RegulationsFederal Regulations
About the role
Key responsibilities & impact- Identify and assess risks in documentation, coding and billing processes
- Assist in avoiding potential fines and penalties from government agencies
- Develop and provide orientation training for new providers
- Perform annual audits of provider billing
- Provide ongoing education to providers and employees involved in preparing or submitting professional bills to federal payers
- Report audit findings to billing providers, administrative and clinical leaders, and non-clinical staff
- Make recommendations based on audit findings
- Collaborate with professional and hospital billing departments, Coding Education, Health Information Management, Revenue Integrity, management, and physician leaders
- Identify billing-related risk areas and conduct audits
- Recommend measures to reduce risk and promote compliance
- Assist with development of the annual Compliance Audit Work Plan
- Ensure organizational policies and audit standards conform to applicable requirements
- Keep current on applicable state and federal regulations
Requirements
What you’ll need- Bachelor's degree in business, health care operations or a clinical field required; substantial work-related auditor experience with academic credentials may substitute
- Master's degree in business or a health care related field preferred
- Must possess certification issued by the American Academy of Professional Coders (AAPC)
- CPC-E/M Auditor certification preferred
- Five years of work-related experience in coding and billing for professional services
- One year of auditing experience
- Knowledge of applicable state and federal regulations pertaining to documentation, coding and billing
- Ability to conduct audits, identify billing-related risk areas, and recommend measures to reduce risk and promote compliance
Benefits
Comp & perks- Full-time employment
- Standard hours: 40
- Day shift
- No weekend requirements