Job Title: Regulatory Services Auditor
FLSA Status: Non-Exempt
We are seeking an exceptional Regulatory Services Auditor to join our team!
We are a multi-specialty, multi-campus group based out of Greenville, NC, offering a wide range of specialties. In addition to primary care, our practice covers pulmonary and critical care medicine, rheumatology, dermatology, oncology, endocrinology, cardiology, obstetrics and gynecology, gastroenterology, surgery, urology, and urgent care. Our team of 102 providers and over 600 employees serves thousands of patients in a 29-county region. We are affiliated with ECU Health, a 900+ bed, level one trauma center and the primary teaching hospital for the East Carolina University Brody School of Medicine (ECU-BSOM).
Located in the coastal plain area, only one hour from the Atlantic Ocean, Greenville is a vibrant center for business, industry, culture, education, and healthcare for eastern North Carolina. With its exceptional quality of life, welcoming community, modern amenities, and easy interstate accessibility, Greenville offers a premier environment for families and individuals alike. Residents enjoy a mild climate and access to rivers and the ocean, making it possible to participate in water sports, golf, tennis, and other outdoor activities year-round.
Some of the benefits you will enjoy include:
- Comprehensive Medical and Prescription Drug Plan
- Reduced co-pays when utilizing our medical providers
- Convenient onsite employee pharmacy with reduced co-pays
- Dental and vision insurance
- Supplemental insurance plans available with payroll deduction
- Employee assistance program at no cost
- Life insurance provided at no cost with additional options
- Generous 401(k) with company matching contributions
- Profit Sharing Program
- Flex Spending program
- Company-paid Short Term and Long Term Disability Insurance
- Generous PTO accrual and paid holidays
- Employee Discounts Programs
- Banking and Mortgage discount programs
- And more!
About us:
We are a team of skilled healthcare professionals dedicated to delivering quality, cost-efficient, comprehensive healthcare to the people of Eastern North Carolina.
About the role:
We are seeking an individual to work in a fast-paced, multi-specialty physician group to conduct in-house audits, provide provider education, and offer coding-related support to ensure accuracy and compliance. This role is predominantly remote with occasional travel to our locations for audit findings delivery and provider education sessions. Training will be a combination of virtual meetings and in-person sessions. Candidates must be located in North Carolina.
Responsibilities:
- Conduct provider and coder audits to ensure coding levels and charting meet standards and regulations.
- Educate providers and team members on compliance audit findings or identified problems.
- Develop ongoing educational content for the coding department and providers.
- Stay up-to-date and knowledgeable on coding processes, diagnostic procedures, carrier-specific policies, guidelines, and updates.
- Share information as necessary with the Coding & Insurance department.
- Provide training and serve as a general resource to assist coders and department staff.
- Communicate current coding practices and changes in regulations and guidelines to providers and team members.
- Collaborate with team leadership to address coding trends.
- Utilize coding resources and reference materials to ensure accuracy.
- Understand billing and coding requirements for government and commercial payers.
- Provide assistance to the Coding or Insurance Department as directed by Regulatory Services Leadership.
- Maintain patient confidentiality.
- Serve as a backup for coding during peak workload periods.
- Assist with special projects as assigned by leadership.
- Work independently and proficiently in a remote office environment.
- Attend meetings when required (onsite/remote).
Location & commitments:
This is a permanent full-time role based out of our Greenville Arlington Blvd. location, Monday-Friday, 8 a.m. - 5 p.m. The candidate will work remotely upon training with 30% travel required. The schedule is flexible. Candidates must be located in North Carolina.
Candidate requirements:
- Associate's or Bachelor's degree in Health Information Management with RHIT/RHIA certification and 3-5 years of multi-specialty ICD-10 and CPT experience, or
- Bachelor's degree in a healthcare-related field with CPC/CCS-P/CPMA certification and 2-4 years of direct ICD-10 and CPT experience, or
- CPC/CCS-P/CPMA certification with 4-6 years of multi-specialty ICD-10 and CPT experience.
Affirmative Action/EEO statement:
We are an equal opportunity employer and do not discriminate against any applicant or employee on the basis of age, race, color, ethnicity, religion, creed, sex (including gender, pregnancy, sexual orientation, and gender identity, including status as a transgender individual), national origin or ancestry, citizenship, past, current, or prospective service in the uniformed services, genetic information (including family medical history), physical or mental disability, or other legally protected status. Reasonable accommodations will be made for persons with disabilities during the application process and/or at the time of employment. Requests for accommodation should be made to the Human Resources Department as early as possible in the application/employment process.
Disclaimer:
This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Employment Type: Full-Time
Salary: $ 80,000.00 160,000.00 Per Year
