The Company:At Cardiovascular Associates of America (CVAUSA), we are building a forward- thinking network of independent, entrepreneurial cardiologists dedicated to improving quality of care, lowering total costs of care, and being on the forefront of efforts to innovate and develop new treatments that improve lives. The CVAUSA network currently spans 23 distinct practices across 8 states, and CVAUSA clinicians collectively serve more than 750,000 unique patients annually.About Us:Join a dedicated team that prioritizes integrity, compliance, and excellence in our organization. We are committed to maintaining the highest standards and ensuring that we align with industry regulations and guidelines. If you’re passionate about making a meaningful impact, we invite you to apply.**THIS IS A REMOTE WORK FROM HOME POSITION***Position Overview: We are on the lookout for a meticulous and dedicated Compliance Auditor to enhance our compliance team. In this pivotal role, you will protect the company’s assets and reputation by ensuring adherence to internal regulations as well as legal and federal requirements. Your expertise will be critical in performing comprehensive medical coding audits, evaluating documentation to confirm compliance with CMS guidelines and applicable payor standards. You will interact closely with various teams, including the Compliance Department, National Support Team, and clinical staff, fostering a culture of education and improvement.To be successful as a Compliance Auditor, you should have excellent attention to detail, analytical, and multitasking skills. Ultimately, a top-notch compliance auditor should be completely objective and possess an in-depth working knowledge of the operations and practices within our industry.  Specifically, the Compliance Auditor will perform medical coding audits. The medical record or progress note will be audited for documentation to ensure compliance with CMS guidelines and applicable payor guidelines. The Compliance Auditor Interacts with employees within the Compliance Department, the National Support Team, and practice staff and physicians.Key Responsibilities:

• Develop Compliance Auditing Plans: Create comprehensive auditing plans grounded in extensive research from government agencies and professional organizations, ensuring that our compliance initiatives are proactive and effective.
• Conduct Audits: Manage and oversee both external and internal audits with diligence, ensuring that all audits are conducted thoroughly and objectively to uphold compliance standards.
• Risk Analysis and Recommendations: Identify potential risks within our operations and practices, providing well-researched recommendations for improving our internal control structures and compliance protocols.
• Reporting: Compile detailed reports summarizing the results of audits and present these findings to relevant supervisors and department heads, ensuring clear communication and actionable insights.
• Ongoing Monitoring and Education: Continuously monitor provider coding and documentation practices, offering support and training based on audit findings, denials, and compliance reviews to enhance the team’s knowledge.
• Clinical Documentation Improvement: Act as an educator for Clinical Documentation Improvement (CDI), focusing on coding accuracy, regulatory compliance, and documentation best practices.
• Data Analysis: Analyze CPT code utilization by providers to identify outliers and trends, ensuring that our coding practices are in line with industry standards and payer requirements.
• Stay Current with Guidelines: Keep abreast of updates in coding guidelines, reimbursement trends, and regulatory changes through ongoing education, workshops, and internal meetings.
• Audit Medical Records: Conduct in-depth audits of medical records to validate the accuracy of all documented diagnoses and procedures, ensuring compliance with coding standards (ICD-9/10, CPT).
• Communicate Findings: Clearly articulate audit findings and recommendations in written reports, advising and educating coders, auditors, managers, and directors throughout the organization.
• Identify Documentation Issues: Proactively identify documentation gaps that affect coding accuracy, communicating these issues effectively to relevant stakeholders for timely resolution.
• Travel Requirements: Be prepared for occasional travel to support audits, training sessions, and educational opportunities.

Qualifications and Skills:

• Experience: A minimum of five (5) years of experience in an acute care setting, specifically in auditing and/or coding management, is essential.
• Educational Background: An associate’s degree or higher in a relevant field is preferred.
• Certifications: Relevant certifications (e.g., RHIA, RHIT, CCS, CPC-H, CCS-P) are highly valued, with preference given to those who are AHIMA-approved ICD-10 trainers.
• Knowledge Base: A strong understanding of clinical documentation, coding guidelines, and healthcare regulations is crucial. Experience with evaluation and management (E&M) level assignment is required.
• Analytical Skills: You must possess exceptional analytical skills and the ability to consistently and accurately audit coding of encounters.
• Communication Skills: Strong written and verbal communication skills are essential for conveying complex information clearly and effectively.
• Attention to Detail: A keen eye for detail is critical, as more than 80% of your role will be spent auditing documentation.
• Technical Proficiency: Proficiency in MS Office and familiarity with medical coding and billing systems are required.
• Interpersonal Skills: You should display excellent interpersonal skills, demonstrating initiative and discipline in managing time and assignments.
• Independent Worker: The ability to work independently in a virtual environment with minimal supervision is essential.
• Commitment to Continuous Learning: A proactive approach to staying current with coding guidelines, legal regulations, and industry trends is vital to your success in this role.
• Remote Opportunity: Individual must be comfortable working remotely and have a fully functioning remote workspace.

Why Join Us?By becoming part of our team, you will play a crucial role in ensuring compliance and promoting best practices. We offer a supportive and collaborative remote work environment, opportunities for professional growth, and the chance to make a significant impact in the healthcare industry. If you are ready to take on a challenging yet rewarding role as a Compliance Auditor, we encourage you to apply!