Compliance RAC Auditor
OSF Saint Francis Medical Center
Date: 13 hours ago
City: Peoria, IL
Salary:
$36.04
-
$42.4
per hour
Contract type: Full time
Job Description
Total Rewards
"Your life - our Mission"
OSF HealthCare is dedicated to provide Mission Partners with a comprehensive and market-competitive total rewards package that includes benefits, compensation, recognition and well-being offerings that focus on the whole person and engage with their current stage of life and career. Click here to learn more about benefits and the total rewards at OSF.
Expected pay for this position is $36.04 - $42.40/hour. Actual pay will be determined by experience, skills and internal equity. This is a Salaried position.
Overview
POSITION SUMMARY: The Compliance Recovery Audit Contractors (RAC) Auditor provides guidance, support and oversight to OSF Healthcare System (OSF) to ensure effective management of all government claim audits such as RAC, Medicare Administrative Contractor (MAC), Comprehensive Error Rate Testing (CERT) and Office of Inspector General (OIG). Responsibilities include: response/appeal process; tracking requests and progress throughout the audit process; evaluating data associated with RAC and other governmental audit activities; tracks and measures the effectiveness of OSF responses and assesses additional potential reimbursement risks due to current RAC and governmental audit activity. Assesses risk, plans, and performs proactive audits to promote compliance with government rules and regulations.
Qualifications
REQUIRED QUALIFICATIONS:
Education
Bachelors degree
Licenses/Certifications
RN-Registered Nurse
Experience
5 years experience in nursing or professional medical coding, billing, compliance or audit in a healthcare setting
Other Skills/knowledge
Solid computer skills, including proficiency with Microsoft software.;
Strong analytical and problem solving skills, with the ability to be detail oriented.
Preferred Qualifications
Experience: Experience with statistical analysis, sampling techniques and reporting methods preferred.
Licensure/Certifications
Certification in professional medical coding, compliance, or audit
Other Skills/Knowledge: The elements of an effective compliance program The essential OIG, DOJ and OCR materials The FCA, the Stark Law, the AKS, the CMP Law and the HIPAA Privacy Rule
Other Requirements/information
Proficient in applying statutory, regulatory and policy provisions to everyday clinical and business activities
Excellent written and oral communication skills to explain often complicated requirements in a clear and concise way
OSF HealthCare is an Equal Opportunity Employer.
Total Rewards
"Your life - our Mission"
OSF HealthCare is dedicated to provide Mission Partners with a comprehensive and market-competitive total rewards package that includes benefits, compensation, recognition and well-being offerings that focus on the whole person and engage with their current stage of life and career. Click here to learn more about benefits and the total rewards at OSF.
Expected pay for this position is $36.04 - $42.40/hour. Actual pay will be determined by experience, skills and internal equity. This is a Salaried position.
Overview
POSITION SUMMARY: The Compliance Recovery Audit Contractors (RAC) Auditor provides guidance, support and oversight to OSF Healthcare System (OSF) to ensure effective management of all government claim audits such as RAC, Medicare Administrative Contractor (MAC), Comprehensive Error Rate Testing (CERT) and Office of Inspector General (OIG). Responsibilities include: response/appeal process; tracking requests and progress throughout the audit process; evaluating data associated with RAC and other governmental audit activities; tracks and measures the effectiveness of OSF responses and assesses additional potential reimbursement risks due to current RAC and governmental audit activity. Assesses risk, plans, and performs proactive audits to promote compliance with government rules and regulations.
Qualifications
REQUIRED QUALIFICATIONS:
Education
Bachelors degree
Licenses/Certifications
RN-Registered Nurse
Experience
5 years experience in nursing or professional medical coding, billing, compliance or audit in a healthcare setting
Other Skills/knowledge
Solid computer skills, including proficiency with Microsoft software.;
Strong analytical and problem solving skills, with the ability to be detail oriented.
Preferred Qualifications
Experience: Experience with statistical analysis, sampling techniques and reporting methods preferred.
Licensure/Certifications
Certification in professional medical coding, compliance, or audit
Other Skills/Knowledge: The elements of an effective compliance program The essential OIG, DOJ and OCR materials The FCA, the Stark Law, the AKS, the CMP Law and the HIPAA Privacy Rule
Other Requirements/information
Proficient in applying statutory, regulatory and policy provisions to everyday clinical and business activities
Excellent written and oral communication skills to explain often complicated requirements in a clear and concise way
OSF HealthCare is an Equal Opportunity Employer.
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