Umpqua Health Management LLC
Eugene, OR, USA
The Role:
The Compliance Quality Auditor is responsible for ensuring accuracy, compliance, and quality in care coordination, preauthorization, medical coding, billing, and documentation. This role involves conducting audits, analyzing claims, and providing education to internal and external partners to improve coding accuracy and adherence internal policies and regulatory guidelines.
Key Responsibilities
Audit & Compliance:
Conduct coding and documentation audits to ensure compliance with CMS, AMA, and other regulatory standards.
Identify discrepancies, errors, and areas for improvement in medical record documentation and coding practices.
Develop corrective action plans to address deficiencies and ensure compliance with policies and procedures
Quality Assurance & Risk Mitigation:
Monitor and analyze coding trends to detect patterns of undercoding, overcoding, or unbundling.
Provide recommendations for process improvement and risk...
Job Specialty: |
Audit
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