Memphis, TN, USA
3 days ago
Credentialing and Auditing Specialist

Job Functions, Duties, Responsibilities and Position Qualifications:

The Compliance Audit Specialist reports to the Director of Compliance and will assist with and support the compliance program activities of American Esoteric Laboratories (AEL).

The Compliance Audit Specialist will support the compliance department through auditing/monitoring, planning, education, assessment, and other compliance program functions including any existing compliance activities, with a particular focus on clinical/billing compliance and data analytics.

This opportunity is:

Location: Memphis, Tn 38134

Days: 40 hrs a week, rotating weekends

Hours: 7:00 am -3:30 pm

Full Time: Benefit Eligible

In this role, you will:

Perform annual compliance department risk assessment to develop annual department work plan  Design data tracking systems to detect, monitor, audit and track data to aid in identifying risk areas and correct non compliancesPrepare compliance audit data by compiling and analyzing internal and external dataManage audits of federal and state exclusion sanctions lists for employees, vendors and clientsMonitor and assist with annual and new hire compliance and HIPAA trainingReview and audit revenue billing cycle  functions including but not limited to, ABNs, standing orders, charge master, and denialsaudit findings, communicate to and recommend corrective strategies to agencyEstablish and refine, as needed, systems to effectively audit and monitor AEL compliance with rules and regulations applying to laboratory operations.Using established inspection tools to identify non-compliances and prepare written reportProvide guidance for corrective action, track completion and monitor success. Participate in employee education

All you need, is:

Bachelor’s Degree in chemical, biological or medical technician, healthcare compliance, health sciences, healthcare data science, and healthcare administration.Preferred: Certification in Healthcare Compliance and/or Certification in Medical Coding and BillingMinimum of three years in laboratory training and/or experience in a medical laboratoryGood knowledge of laboratory medicine at both the technical and administrative levelsHighly developed analytical skills for both qualitative and quantitative dataAbility to plan and lead projects following tight deadlinesDemonstrates a high-level of attention to detail and accuracyExcellent communication skills - strong verbal and written skills

We’ll give you:

Appreciation for your workA feeling of satisfaction that you’ve helped peopleOpportunity to grow in your professionFree lab services for you and your dependentsWork-life balance, including Paid Time Off and Paid HolidaysCompetitive benefits including medical, dental, and vision insuranceHelp saving for retirement, with a 401(k) plus a company matchA sense of belonging – we’re a community!

Scheduled Weekly Hours:

40

Work Shift:

Job Category:

Administration

Company:

We also want you to know:

This role will have routine access to Protected Health Information (PHI). Employees will be trained on reasonable safeguards and are expected to maintain strict confidentiality, as well as abide by all applicable privacy and security standards.  Employees are expected only to access PHI when it is required to fulfill job duties.

Sonic Healthcare USA is an equal opportunity employer that celebrates diversity and is committed to an inclusive workplace for all employees. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, age, national origin, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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