Compliance Audit Nurse

Works closely with the Compliance Committee, and the Executive Administrator to ensure compliance with government payor rules and regulations throughout the Clinic. Tasks and responsibilities, consist of, but are not limited to, the following: conducting compliance-related and quality review audits; monitoring compliance throughout organization with Code of Conduct; maintaining up-to-date knowledge of billing, coding, and documentation regulations as they change from time to time, providing feedback to staff, management, and physicians on compliance-related activities; developing staff and physician training materials no less than annually, and maintaining awareness of and developing and audit program to address OIG's Work List priorites. This position reports directly to the Executive Administrator.

Critical Responsibilities:

1. Conduct various compliance-related audits with respect to documentation and reimbursement;
2. Develop annual staff and physician compliance training;
3. Monitor compliance throughout organization with Code of Conduct;
4. Educate physicians on billing, documentation, and coding requirements;
5. Research and communicate changing Medicare regulations and requirements as necessary;
6. Review and update MCH Compliance Policy and Procedures at least annually; and
7. Assist in other areas as needed.
   

Background Requirements:

Education, Experience, and Knowledge

• Texas Registered Nurse with Bachelors degree plus CPC, CPMA, or CCS-P.
• Two or more years of compliance audit experience preferred.
• Knowledge of coding systems: ICD-9, CPT, and HCPCS.
• Basic knowledge of and interest in Medicare billing rules and regulations.

Skills and Abilities

• Must demonstrate excellent communication skills.
• Must demonstrate excellent organizational skills.
• Must demonstrate excellent interpersonal skills.
• Experience working with NextGen is a plus.
• Ability to establish collaborative relationships with members of the medical and administrative staff.

Clinic Information:

• MCH has provided internal medicine and sub-specialty care to Houstonians for over 40 years
• 35 physicians currently seeing 100,000 patient visits per year
• New state-of-the-art building
• High performance management team with a focus on patient care

Benefits:

• Competitive compensation package
• Free parking
• Health, dental, and life benefits, 401K, and paid time off

E-mail resumes to mchjobs@mchllp.com. Please make note of the position you are applying for in the subject line of your e-mail.

Current employees interested in applying for this position should refer to Policy VIII in the Employee Handbook for the proper procedures to be followed for transfers. In addition, please see Policy II in the Employee Handbook regarding referral bonuses.