Enterprise Provider Compliance Auditor-Educator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now!
WVU Medicine
Enterprise Provider Compliance Auditor-Educator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now!
Job Description
Enterprise Provider Compliance Auditor-Educator at WVU Medicine
Role Overview
The Enterprise Provider Compliance Auditor-Educator plays a critical role in ensuring that WVU Medicine and its affiliates adhere to all relevant federal healthcare program rules, regulations, and administrative requirements. This position involves conducting compliance audits, developing educational programs, and collaborating with various departments to maintain a robust compliance framework. The auditor-educator will work under the guidance of the Director of Provider Compliance and the VP of Corporate Compliance to prevent fraud, waste, and abuse across the organization.Day in the Life
A typical day for the Enterprise Provider Compliance Auditor-Educator might include:- Conducting compliance audits and reviews of medical records, billing documentation, and other relevant materials.
- Analyzing data to identify potential compliance issues and areas for improvement.
- Developing and writing detailed audit reports outlining findings, recommendations, and corrective actions.
- Leading meetings with department representatives to discuss audit results and develop action plans.
- Researching and interpreting regulatory requirements related to healthcare compliance.
- Creating and delivering educational presentations and training sessions for internal and external stakeholders.
- Collaborating with the Director of Provider Compliance and VP of Corporate Compliance to develop and implement compliance policies and procedures.
- Staying up-to-date with changes in healthcare regulations and industry best practices.
- Assisting with the development and maintenance of compliance monitoring systems.
- Responding to compliance inquiries and providing guidance to staff members.
Why Morgantown, West Virginia?
Morgantown, West Virginia, offers a unique blend of small-town charm and big-city amenities. As the home of West Virginia University, Morgantown has a vibrant cultural scene, with numerous restaurants, shops, and entertainment options. The city is also surrounded by beautiful natural landscapes, offering opportunities for outdoor activities such as hiking, biking, and fishing. Morgantown’s cost of living is generally lower than the national average, making it an attractive place to live and work. The city also boasts a strong sense of community and a welcoming atmosphere.Career Path
The Enterprise Provider Compliance Auditor-Educator role can serve as a stepping stone to various career advancement opportunities within WVU Medicine. Potential career paths may include:- Senior Compliance Auditor
- Compliance Manager
- Director of Provider Compliance
- VP of Corporate Compliance
- Compliance Officer
Salary & Benefits
The estimated salary range for the Enterprise Provider Compliance Auditor-Educator position in Morgantown, West Virginia, is $65,000 to $95,000 per year. Actual salary may vary depending on experience, qualifications, and other factors. WVU Medicine offers a comprehensive benefits package, including:- Comprehensive health insurance (medical, dental, vision)
- Paid time off (PTO) and vacation time
- Retirement plan with employer matching
- Life insurance
- Disability insurance (short-term and long-term)
- Employee assistance program (EAP)
- Wellness programs
- Professional development opportunities
- Tuition reimbursement
- Employee discounts
- Flexible spending accounts (FSA)
- Health savings accounts (HSA)
- Dependent care assistance
WVU Medicine Culture
WVU Medicine is committed to providing exceptional patient care, fostering a culture of teamwork and collaboration, and promoting the professional growth of its employees. The organization values diversity, inclusion, and respect for all individuals. WVU Medicine encourages innovation and continuous improvement in all aspects of its operations.How to Apply
To apply for the Enterprise Provider Compliance Auditor-Educator position, please click the “Apply” button located at the top of this page and complete the application in full. Be sure to highlight your relevant experience, qualifications, and certifications. If you meet the minimum requirements for the position, you may be contacted for an interview.FAQ
- What are the minimum qualifications for this position? The minimum qualifications include a High School Diploma or Equivalent AND Seven (7) Years of extensive experience in multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines” OR an Associate’s Degree AND Five (5) years extensive experience in multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines”. Also required is a Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), OR Certified Coding Specialist- Physician (CCS-P).
- What are the preferred qualifications? A Bachelor’s Degree is preferred.
- What are the core duties and responsibilities of this role? The core duties include conducting compliance-related audits and reviews, coordinating with departments to conduct compliance audits, researching regulatory requirements, reviewing medical records, developing audit reports, leading meetings, and conducting educational presentations.
- What skills are important for success in this role? Important skills include auditing, compliance, medical coding, data analysis, report writing, presentation skills, training, and regulatory research.
- What is the salary range for this position? The estimated salary range is $65,000 to $95,000 per year.
- What benefits does WVU Medicine offer? WVU Medicine offers a comprehensive benefits package, including health insurance, paid time off, retirement plan, life insurance, disability insurance, and more.
- What is the work environment like at WVU Medicine? WVU Medicine fosters a culture of teamwork, collaboration, and respect.
- What opportunities are there for professional development? WVU Medicine offers various professional development opportunities, including training programs and tuition reimbursement.
- How can I advance my career at WVU Medicine? The Enterprise Provider Compliance Auditor-Educator role can lead to various career advancement opportunities within the organization, such as Senior Compliance Auditor, Compliance Manager, and Director of Provider Compliance.
- Is relocation assistance available for this position? Relocation assistance may be available for qualified candidates. Please inquire with the hiring manager for more information.
Locations
- Morgantown, West Virginia, United States
Salary
Estimated Salary Rangemedium confidence
71,500 - 104,500 USD / yearly
Source: ai estimated
* This is an estimated range based on market data and may vary based on experience and qualifications.
Skills Required
- Auditingintermediate
- Complianceintermediate
- Medical Codingintermediate
- E&M Codingintermediate
- Procedural Codingintermediate
- Surgical Codingintermediate
- Billing Regulationsintermediate
- Teaching Physician Guidelinesintermediate
- Data Analysisintermediate
- Report Writingintermediate
- Presentation Skillsintermediate
- Trainingintermediate
- Educationintermediate
- Regulatory Researchintermediate
- Medical Record Reviewintermediate
Required Qualifications
- High School Diploma or Equivalent AND Seven (7) Years of extensive experience in multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines” OR (experience)
- Associate’s Degree AND Five (5) years extensive experience in multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines”. (experience)
- Certified Professional Coder (CPC) (experience)
- Registered Health Information Technician (RHIT) (experience)
- Certified Coding Specialist- Physician (CCS-P) (experience)
- Knowledge of CMS rules and regulations (experience)
- Knowledge of multistate regulations (WV, OH, PA, MD) (experience)
- Knowledge of payor-specific regulations (experience)
- Understanding of chart documentation requirements (experience)
- Knowledge of valid coding and billing practices (experience)
- Understanding of medical necessity support (experience)
- Ability to prevent fraud, waste, and abuse (experience)
- Familiarity with OIG compliance program requirements (experience)
- Ability to conduct data analytical reports (experience)
- Strong research skills (experience)
- Excellent written and verbal communication skills (experience)
Responsibilities
- Conduct compliance-related audits and reviews.
- Coordinate with departments to conduct compliance audits and reviews.
- Consider rules and regulations for CMS, multistate (WV, OH, PA, MD, etc.), and payor-specific regulations for chart documentation, valid coding and billing, and medical necessity support.
- Prevent fraud, waste, and abuse as mandated by OIG compliance program requirements.
- Conduct audits across WVUHS and all its affiliates.
- Evaluate the scope of the audit.
- Develop and complete required compilation of data analytical reports.
- Identify the audit universe and select the appropriate sample based on the scope of the audit criteria.
- Formulate and define the scope and objectives of audit or review, along with the Director of Provider Compliance and VP of Corporate Compliance.
- Research regulatory requirements that pertain to the audit or review.
- Review medical record, billing, or other relevant documentation.
- Develop and write audit reports which outline audit findings, recommendations, and corrective actions as needed.
- Lead and conduct meetings with respective departments or individuals to review audit reports and develop corrective action plans as necessary.
- Plan, develop, and conduct presentations for internal and external departments.
- Coordinate educational activities with the Director of Provider Compliance and VP of Corporate compliance to ensure organizational compliance education needs are met.
- Conduct and/or facilitate audit training/education activities of the Compliance Department.
Benefits
- general: Comprehensive health insurance (medical, dental, vision)
- general: Paid time off (PTO) and vacation time
- general: Retirement plan with employer matching
- general: Life insurance
- general: Disability insurance (short-term and long-term)
- general: Employee assistance program (EAP)
- general: Wellness programs
- general: Professional development opportunities
- general: Tuition reimbursement
- general: Employee discounts
- general: Flexible spending accounts (FSA)
- general: Health savings accounts (HSA)
- general: Dependent care assistance
- general: Relocation assistance (if applicable)
- general: Commuting benefits
- general: On-site childcare (availability may vary)
- general: Employee recognition programs
- general: Career advancement opportunities within WVU Medicine
Tags & Categories
Answer 10 quick questions to check your fit for Enterprise Provider Compliance Auditor-Educator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now! @ WVU Medicine.
10 Questions
~2 Minutes
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Enterprise Provider Compliance Auditor-Educator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now!
WVU Medicine
Enterprise Provider Compliance Auditor-Educator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now!
Job Description
Enterprise Provider Compliance Auditor-Educator at WVU Medicine
Role Overview
The Enterprise Provider Compliance Auditor-Educator plays a critical role in ensuring that WVU Medicine and its affiliates adhere to all relevant federal healthcare program rules, regulations, and administrative requirements. This position involves conducting compliance audits, developing educational programs, and collaborating with various departments to maintain a robust compliance framework. The auditor-educator will work under the guidance of the Director of Provider Compliance and the VP of Corporate Compliance to prevent fraud, waste, and abuse across the organization.Day in the Life
A typical day for the Enterprise Provider Compliance Auditor-Educator might include:- Conducting compliance audits and reviews of medical records, billing documentation, and other relevant materials.
- Analyzing data to identify potential compliance issues and areas for improvement.
- Developing and writing detailed audit reports outlining findings, recommendations, and corrective actions.
- Leading meetings with department representatives to discuss audit results and develop action plans.
- Researching and interpreting regulatory requirements related to healthcare compliance.
- Creating and delivering educational presentations and training sessions for internal and external stakeholders.
- Collaborating with the Director of Provider Compliance and VP of Corporate Compliance to develop and implement compliance policies and procedures.
- Staying up-to-date with changes in healthcare regulations and industry best practices.
- Assisting with the development and maintenance of compliance monitoring systems.
- Responding to compliance inquiries and providing guidance to staff members.
Why Morgantown, West Virginia?
Morgantown, West Virginia, offers a unique blend of small-town charm and big-city amenities. As the home of West Virginia University, Morgantown has a vibrant cultural scene, with numerous restaurants, shops, and entertainment options. The city is also surrounded by beautiful natural landscapes, offering opportunities for outdoor activities such as hiking, biking, and fishing. Morgantown’s cost of living is generally lower than the national average, making it an attractive place to live and work. The city also boasts a strong sense of community and a welcoming atmosphere.Career Path
The Enterprise Provider Compliance Auditor-Educator role can serve as a stepping stone to various career advancement opportunities within WVU Medicine. Potential career paths may include:- Senior Compliance Auditor
- Compliance Manager
- Director of Provider Compliance
- VP of Corporate Compliance
- Compliance Officer
Salary & Benefits
The estimated salary range for the Enterprise Provider Compliance Auditor-Educator position in Morgantown, West Virginia, is $65,000 to $95,000 per year. Actual salary may vary depending on experience, qualifications, and other factors. WVU Medicine offers a comprehensive benefits package, including:- Comprehensive health insurance (medical, dental, vision)
- Paid time off (PTO) and vacation time
- Retirement plan with employer matching
- Life insurance
- Disability insurance (short-term and long-term)
- Employee assistance program (EAP)
- Wellness programs
- Professional development opportunities
- Tuition reimbursement
- Employee discounts
- Flexible spending accounts (FSA)
- Health savings accounts (HSA)
- Dependent care assistance
WVU Medicine Culture
WVU Medicine is committed to providing exceptional patient care, fostering a culture of teamwork and collaboration, and promoting the professional growth of its employees. The organization values diversity, inclusion, and respect for all individuals. WVU Medicine encourages innovation and continuous improvement in all aspects of its operations.How to Apply
To apply for the Enterprise Provider Compliance Auditor-Educator position, please click the “Apply” button located at the top of this page and complete the application in full. Be sure to highlight your relevant experience, qualifications, and certifications. If you meet the minimum requirements for the position, you may be contacted for an interview.FAQ
- What are the minimum qualifications for this position? The minimum qualifications include a High School Diploma or Equivalent AND Seven (7) Years of extensive experience in multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines” OR an Associate’s Degree AND Five (5) years extensive experience in multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines”. Also required is a Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), OR Certified Coding Specialist- Physician (CCS-P).
- What are the preferred qualifications? A Bachelor’s Degree is preferred.
- What are the core duties and responsibilities of this role? The core duties include conducting compliance-related audits and reviews, coordinating with departments to conduct compliance audits, researching regulatory requirements, reviewing medical records, developing audit reports, leading meetings, and conducting educational presentations.
- What skills are important for success in this role? Important skills include auditing, compliance, medical coding, data analysis, report writing, presentation skills, training, and regulatory research.
- What is the salary range for this position? The estimated salary range is $65,000 to $95,000 per year.
- What benefits does WVU Medicine offer? WVU Medicine offers a comprehensive benefits package, including health insurance, paid time off, retirement plan, life insurance, disability insurance, and more.
- What is the work environment like at WVU Medicine? WVU Medicine fosters a culture of teamwork, collaboration, and respect.
- What opportunities are there for professional development? WVU Medicine offers various professional development opportunities, including training programs and tuition reimbursement.
- How can I advance my career at WVU Medicine? The Enterprise Provider Compliance Auditor-Educator role can lead to various career advancement opportunities within the organization, such as Senior Compliance Auditor, Compliance Manager, and Director of Provider Compliance.
- Is relocation assistance available for this position? Relocation assistance may be available for qualified candidates. Please inquire with the hiring manager for more information.
Locations
- Morgantown, West Virginia, United States
Salary
Estimated Salary Rangemedium confidence
71,500 - 104,500 USD / yearly
Source: ai estimated
* This is an estimated range based on market data and may vary based on experience and qualifications.
Skills Required
- Auditingintermediate
- Complianceintermediate
- Medical Codingintermediate
- E&M Codingintermediate
- Procedural Codingintermediate
- Surgical Codingintermediate
- Billing Regulationsintermediate
- Teaching Physician Guidelinesintermediate
- Data Analysisintermediate
- Report Writingintermediate
- Presentation Skillsintermediate
- Trainingintermediate
- Educationintermediate
- Regulatory Researchintermediate
- Medical Record Reviewintermediate
Required Qualifications
- High School Diploma or Equivalent AND Seven (7) Years of extensive experience in multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines” OR (experience)
- Associate’s Degree AND Five (5) years extensive experience in multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the “Teaching Physician Guidelines”. (experience)
- Certified Professional Coder (CPC) (experience)
- Registered Health Information Technician (RHIT) (experience)
- Certified Coding Specialist- Physician (CCS-P) (experience)
- Knowledge of CMS rules and regulations (experience)
- Knowledge of multistate regulations (WV, OH, PA, MD) (experience)
- Knowledge of payor-specific regulations (experience)
- Understanding of chart documentation requirements (experience)
- Knowledge of valid coding and billing practices (experience)
- Understanding of medical necessity support (experience)
- Ability to prevent fraud, waste, and abuse (experience)
- Familiarity with OIG compliance program requirements (experience)
- Ability to conduct data analytical reports (experience)
- Strong research skills (experience)
- Excellent written and verbal communication skills (experience)
Responsibilities
- Conduct compliance-related audits and reviews.
- Coordinate with departments to conduct compliance audits and reviews.
- Consider rules and regulations for CMS, multistate (WV, OH, PA, MD, etc.), and payor-specific regulations for chart documentation, valid coding and billing, and medical necessity support.
- Prevent fraud, waste, and abuse as mandated by OIG compliance program requirements.
- Conduct audits across WVUHS and all its affiliates.
- Evaluate the scope of the audit.
- Develop and complete required compilation of data analytical reports.
- Identify the audit universe and select the appropriate sample based on the scope of the audit criteria.
- Formulate and define the scope and objectives of audit or review, along with the Director of Provider Compliance and VP of Corporate Compliance.
- Research regulatory requirements that pertain to the audit or review.
- Review medical record, billing, or other relevant documentation.
- Develop and write audit reports which outline audit findings, recommendations, and corrective actions as needed.
- Lead and conduct meetings with respective departments or individuals to review audit reports and develop corrective action plans as necessary.
- Plan, develop, and conduct presentations for internal and external departments.
- Coordinate educational activities with the Director of Provider Compliance and VP of Corporate compliance to ensure organizational compliance education needs are met.
- Conduct and/or facilitate audit training/education activities of the Compliance Department.
Benefits
- general: Comprehensive health insurance (medical, dental, vision)
- general: Paid time off (PTO) and vacation time
- general: Retirement plan with employer matching
- general: Life insurance
- general: Disability insurance (short-term and long-term)
- general: Employee assistance program (EAP)
- general: Wellness programs
- general: Professional development opportunities
- general: Tuition reimbursement
- general: Employee discounts
- general: Flexible spending accounts (FSA)
- general: Health savings accounts (HSA)
- general: Dependent care assistance
- general: Relocation assistance (if applicable)
- general: Commuting benefits
- general: On-site childcare (availability may vary)
- general: Employee recognition programs
- general: Career advancement opportunities within WVU Medicine
Tags & Categories
Answer 10 quick questions to check your fit for Enterprise Provider Compliance Auditor-Educator Careers at WVU Medicine - Morgantown, West Virginia | Apply Now! @ WVU Medicine.
10 Questions
~2 Minutes
Instant Score
Related Books and Jobs