About Geisinger
Geisinger is committed to delivering exceptional healthcare while fostering a culture of kindness, excellence, learning, innovation, and safety. Serving patients, members, students, employees, and communities, Geisinger values collaboration, diversity, and inclusion as part of its mission to improve health outcomes.
Role Overview
The Compliance Auditor supports Geisinger’s Revenue Management Compliance department by developing, implementing, and administering compliance programs. The auditor ensures accurate medical record documentation, coding, and billing while providing guidance and audit support to physicians, non-physician practitioners, leadership, and administrative staff.
Key Responsibilities
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Conduct compliance audits of medical records, billing, and coding, ensuring alignment with policies, procedures, and federal/state regulations.
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Evaluate documentation and coding patterns to identify potential compliance risks and recommend corrective actions.
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Identify training and education needs based on audit results and support staff education.
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Serve as a clinical coding subject matter expert for multiple specialties.
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Maintain expertise in State and Federal healthcare program regulations.
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Collaborate with revenue cycle staff to review systems and workflows for compliance.
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Define audit scope, key control points, and examination criteria for assigned areas.
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Analyze evidentiary data to form objective opinions on system effectiveness and recommend improvements.
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Prepare executive briefs and reports on audit findings.
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Assess corrective actions taken by management following external audits.
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Provide input for compliance risk assessment and mitigation strategies.
Required Qualifications
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Minimum of 6 years relevant experience.
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High School Diploma or GED required; degree can substitute for experience (Associate = 2 years, Bachelor = 4 years).
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Minimum one coding certification required:
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Certified Professional Coder (AAPC)
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Certified Risk Adjustment Coder (AAPC)
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Registered Health Information Technician (RHIT, AHIMA)
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Skills & Competencies
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Strong knowledge of medical coding, documentation, and compliance standards.
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Analytical, detail-oriented, and critical thinking skills.
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Ability to manage confidential information with discretion.
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Strong communication and training skills.
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Proficiency in reviewing complex healthcare documentation and coding workflows.
Work Environment & Values
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Office-based work environment.
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Geisinger emphasizes a culture of collaboration, cooperation, and collegiality.
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Diversity and inclusion are integral to the team and patient care.
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Geisinger is an affirmative action, equal opportunity employer.