• Job Description

  Req#: 93332
  Total Rewards
  
  

  "Your life - our Mission"

  OSF HealthCare is dedicated to provide Mission Partners with a comprehensive and market-competitive total rewards package that includes benefits, compensation, recognition and well-being offerings that focus on the whole person and engage with their current stage of life and career. Click here to learn more about benefits and the total rewards at OSF.

  Expected pay for this position is $36.04 - $42.40/hour. Actual pay will be determined by experience, skills and internal equity. This is a Salaried position.

  
  Overview
  
  

  POSITION SUMMARY: The Compliance Recovery Audit Contractors (RAC) Auditor provides guidance, support and oversight to OSF Healthcare System (OSF) to ensure effective management of all government claim audits such as RAC, Medicare Administrative Contractor (MAC), Comprehensive Error Rate Testing (CERT) and Office of Inspector General (OIG). Responsibilities include: response/appeal process; tracking requests and progress throughout the audit process; evaluating data associated with RAC and other governmental audit activities; tracks and measures the effectiveness of OSF responses and assesses additional potential reimbursement risks due to current RAC and governmental audit activity. Assesses risk, plans, and performs proactive audits to promote compliance with government rules and regulations.

  
  Qualifications
  
  

  REQUIRED QUALIFICATIONS:

  Education:

  Bachelors degree

  Licenses/Certifications:

  RN-Registered Nurse

  Experience:

  5 years experience in nursing or professional medical coding, billing, compliance or audit in a healthcare setting

  Other skills/knowledge:

  Solid computer skills, including proficiency with Microsoft software.;

  Strong analytical and problem solving skills, with the ability to be detail oriented.

  PREFERRED QUALIFICATIONS:

  Experience: Experience with statistical analysis, sampling techniques and reporting methods preferred.

  Licensure/Certifications:

  Certification in professional medical coding, compliance, or audit

  Other Skills/Knowledge: The elements of an effective compliance program The essential OIG, DOJ and OCR materials The FCA, the Stark Law, the AKS, the CMP Law and the HIPAA Privacy Rule

  Other requirements/information:

  Proficient in applying statutory, regulatory and policy provisions to everyday clinical and business activities

  Excellent written and oral communication skills to explain often complicated requirements in a clear and concise way

  OSF HealthCare is an Equal Opportunity Employer.

  
  

  REQUIRED QUALIFICATIONS:

  Education:

  Bachelors degree

  Licenses/Certifications:

  RN-Registered Nurse

  Experience:

  5 years experience in nursing or professional medical coding, billing, compliance or audit in a healthcare setting

  Other skills/knowledge:

  Solid computer skills, including proficiency with Microsoft software.;

  Strong analytical and problem solving skills, with the ability to be detail oriented.

  PREFERRED QUALIFICATIONS:

  Experience: Experience with statistical analysis, sampling techniques and reporting methods preferred.

  Licensure/Certifications:

  Certification in professional medical coding, compliance, or audit

  Other Skills/Knowledge: The elements of an effective compliance program The essential OIG, DOJ and OCR materials The FCA, the Stark Law, the AKS, the CMP Law and the HIPAA Privacy Rule

  Other requirements/information:

  Proficient in applying statutory, regulatory and policy provisions to everyday clinical and business activities

  Excellent written and oral communication skills to explain often complicated requirements in a clear and concise way

  OSF HealthCare is an Equal Opportunity Employer.

• About the company

  OSF HealthCare is a not-for-profit Catholic health care organization that operates a medical group, hospital system, and other health care facilities in Illinois and Michigan.

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