Institutional Compliance Auditor

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Who We Are:

Life Bridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to “improve the health of people in the communities we serve.” Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care.

• The Compliance Auditor supports the Life Bridge Health Compliance Program by conducting assigned compliance audits, education, and other compliance activities to ensure institutional compliance with Local, State and Federal laws/regulations/requirements, documentation/coding/billing regulations/guidelines, and internal policies/procedures are met. The Compliance Auditor reports to the Director of Institutional Compliance and works collaboratively with leadership, employees, and providers across Life Bridge Health.

• Conduct outpatient and inpatient hospital, post-acute care (DME, Home Care, etc.), and other facility or specific program audits as assigned.
• Analyze audit findings and determine if the auditee is compliant with applicable laws, regulations, and/or documentation/coding/billing requirements or other requirements.
• Prepare draft reports in accordance with Institutional Compliance work standards.
• Participate in exit meetings with auditees.
• Research, compile, analyze, and draft audit topic specific information in preparation for completing assigned audits.
• Research audit topic to determine applicable requirements and regulations, obtain internal information necessary for audit, and develop draft audit tool(s).
• Contribute to the audit plan (scope, time period for review, sample and sample size, etc.) and analyze audit data file(s) for accuracy of inclusion of requested data elements and identify any trends/patterns.
• Develop and conduct compliance education as assigned, for clinicians, leadership, employees, and others.
• Review, research, and compile local, state, and federal regulatory information; coding, billing, and documentation requirements; and other related information.
• Analyze regulatory and other pertinent information and draft a summary of requirements.
• Conduct education in relation to audits, compliance inquiries, institutional policies and requirements related to laws, regulations, etc.
• Research and respond to compliance inquiries. Review, research, and respond to regulatory, billing, coding, documentation, and other inquiries from providers, leadership, employees, and others within the Life Bridge Health System.
• Support the Compliance Officer/Compliance Leadership with the investigation of any issues of potential non-compliance.
• Complete all assigned investigational tasks timely.
• Conduct research related to the topic under investigation.
• Conduct audits as part of an investigation to determine compliance with coding, billing, and documentation regulations/guidelines.
• Continuously seek opportunities to build internal and external relationships and maintain industry knowledge to perform all assigned tasks.
• Maintain basic knowledge of Local, State and Federal laws and regulations, the Centers for Medicare and Medicaid Services’ (CMS) conditions of participation and payment for hospitals, and Long-Term Care regulations.

• Education:
  
  Associate's degree preferred.
• Experience:
  
  1-3 years.
• Licenses/Certification:
  Preferred Certified Inpatient Coder: CCS, COC or CHC.

Salary range $70 to $88K

• Impact:
  Join a team that values innovation and outcomes, delivering life-saving care to our youngest and most vulnerable patients.
• Growth:
  Opportunities for professional development, including tuition reimbursement and developing foundational skills for neonatal critical care leadership and advanced certification.
• Support: A culture of collaboration with resources like unit-based practice councils and advanced clinical education support — improving both workflow efficiency and patient outcomes and allowing you to work at the top of your license.
• Benefits:
  Competitive compensation (additional compensation such as overtime, shift…