Prof Rev Compliance Auditor & Educator
 Yale New Haven Health | |
 United States, Connecticut, New Haven | |
 Sep 27, 2025 | |
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Overview
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. The primary focus of the position is to provide education and conduct audits for the physicians and their staff. Assists in the planning, organizing, and completion of auditing activities required to comply with federal payors and other compliance-related requirements. To identify lost revenue opportunities and any overpayments made due to errors in coding, insufficient medical record documentation, etc. To increase and strengthen health care providers' awareness and understanding of medical record documentation guidelines and coding principles. Serves as a role model for ethical management behavior and promotes an awareness and understanding of the System's Code of Conduct and Privacy and Corporate Compliance Program. Assists the Manager, NEMG Revenue Integrity in assessing risk and developing an audit and education plan to support the overall compliance plan. Interacts with all levels of management within the Health System. EEO/AA/Disability/Veteran Responsibilities
Qualifications EDUCATION Certified Professional Coder required. Associate's Degree in Accounting, Business Administration or Healthcare Administration preferred. EXPERIENCE Minimum of five (5) years experience in a healthcare setting with experience performing medical record audits for clinical documentation, charge and reimbursement accuracy. Demonstrated training and presentation skills. Minimum 3 years E&M coding experience. Experience in hospital and provider coding with CPT and ICD-9-CM. Knowledge of health care management in terms of financial and billing concepts. Knowledge of health care compliance, reimbursement and managed care issues. SPECIAL SKILLS Must be proficient in Microsoft Word, and Excel. Experience with audit software tools preferred. YNHHS Requisition ID 159901 | |