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Compliance Auditor

Casa Colina Centers for Rehabilitation

Pomona, CA

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JOB DETAILS
SALARY
$43–$45 Per Hour
SKILLS
Apple Macs, Auditing, Case Management, Centers for Medicare and Medicaid Services (CMS), Content Management Systems (CMS), Cross-Functional, Current Procedural Terminology (CPT), Data Analysis, Data Entry, Detail Oriented, Documentation, Electronic Medical Records, Government, Health Information Management, Healthcare Common Procedure Coding System (HCPCS), Healthcare Reimbursement, High School Diploma, Hospital, Internet Portal, Leadership, Mail Processing, Medical Billing, Medical Records, Medicare, Microsoft Excel, Microsoft Word, Nursing, Organizational Skills, Outpatient Care, Patient Assessment, Patient Care, Presentation/Verbal Skills, Printing, Problem Solving Skills, Regulatory Compliance, Time Management, Trend Analysis, Typing, Website Management, Writing Skills
LOCATION
Pomona, CA
POSTED
Today
The Prospective Payment System (PPS) Coordinator is responsible for coordinating and managing all activities related to the Inpatient Rehabilitation Facility Prospective Payment System (IRFâ€'PPS). This role ensures the accurate, timely, and compliant completion of patient assessment data, supporting regulatory compliance and appropriate reimbursement. The PPS Coordinator collaborates with interdisciplinary teams including physicians, nursing, therapy services, case management, and Health Information Management (HIM) to ensure documentation reflects the patient#s clinical condition and functional status in accordance with CMS guidelines. # Pay:#$43.00-$45.00/hr #This position performs concurrent review audits and post-discharge audits for meeting requirements for the Centers for Medicare & Medicaid Services' (CMS programs and medical record/financially based audits for acute, ambulatory surgery, observation, and rehabilitation inpatients and outpatients. Has accountability for daily management, auditing, data entry, monitoring, tracking, and communication of audit and appeal findings and activities. Provides data, analysis, and reports for internal and external reporting. Assures the organization responds within designated timeframes to requests for medical records and for various levels of government audit and appeals. Monitors the CMS and MAC websites for updates, training events, review and appeal status responses and distributes information as appropriate to internal leadership. Assists with updating of HCPCS/CPT codes and revenue codes for the chargemasterThe ideal applicant will possess the following:* Minimum high school diploma or GED* Minimum three years of Doing Medicare hospital inpatient and outpatient billing.* Proficient in use of CMS and MAC websites and portals* Proficient and accurate in CPT/HCPCS coding for hospitals* Proficient and accurate in typing and data entry* Familiarity with electronic medical record documents and printing of same preferred* Strong organizational skills with a high level of accuracy and attention to detail.* Ability to synthesize information and concisely communicate verbally and in writing, findings and trend analyses.* Strong presentation skills with the ability to feel comfortable in presenting/defending audit logic to key stakeholders Including physicians, clinicians, and non-clinical staff* Experience working with cross-functional departments to research and resolve issues. Proficient in use of Microsoft Word and Excel.

About the Company

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Casa Colina Centers for Rehabilitation

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