Responsible for conducting examinations and evaluations of the adequacy and effectiveness of the organization's compliance initiatives. Participates in reviews related to performance quality of assigned responsibilities as defined by the organizations Compliance template or Compliance committees.
Responsible for reviewing the reliability and integrity compliance and coding information and the means used to identify, measure, classify and report such information.
Reviews systems established to ensure compliance with policies, plans, procedures, laws and regulations, which have significant impact on operations and reports in determining organizational compliance.
Reviews operations or programs to ascertain whether results are consistent with the established objectives and goals and whether the operations or programs are carried out as planned.
Determines audit plan and program of examination for the assigned areas being audited.
Responsible for surveying the functions and activities in the assigned areas being audited to determine the nature of operations and adequacy of the system to achieve established objectives Identifies key control points of assigned areas being audited.
Responsible for obtaining, analyzing, and appraising evidentiary data and available information as a basis for an informed, objective opinion on the adequacy and effectiveness of the system and the performance of assigned areas being audited Prepares executive briefs showing the results of assigned areas being audited in accordance with those practices followed within the general scope of the audit parameters.
Appraises the adequacy of corrective action taken by management to improve the findings noted in an audit engagement through performing assigned follow-up audit engagements.
Prepares or assists in preparing formal written audit reports and follow up memorandums expressing opinions on the adequacy and effectiveness of the system and the efficiency with which activities are carried out for the assigned areas being audited.
Responsible for providing input to the audit planning process to determine which audit engagements should be preformed as directed by the Compliance Officer or Senior Leadership achieves department specific performance parameters for audit confidence.
Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. *Relevant experience may be a combination of related work experience and degree obtained (Associate's Degree = 2 years; Bachelor's Degree = 4 years).
Please read the qualifications carefully for this position. Coding Certification is a MUST.
High School Diploma or Equivalent (GED)- (Required)
Minimum of 8 years-Relevant experience* (Required)
Certification(s) and License(s)
Certified Risk Adjustment Coder - American Academy of Professional Coders (AAPC); Certified Professional Coder - American Academy of Professional Coders (AAPC); Registered Health Information Technician (RHIT) - American Health Information Management Association
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.
We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh FoodFarmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencingprograms, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 1...3 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers. What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.