• Company Compliance Auditor for IATF and member of the internal auditor team.
• Lead oversight of all corrective actions for compliance.
• Directed customer audits
• Managed and maintained the Document Control database.
- Compliance Auditor at NTN Bearing Corporation
- IATF (TS) Lead Auditor/ Environmental Lead Auditor/Gage Coordinator at ATF, Inc
- Quality Control Manager at
- Research and Development / Raw Material Technician at Colwell North America
4 months at this Job
- Associate of Science - Business Marketing
A compliance auditor assists advocates with grievances such as process to enter out-of-network providers into in-network providers, lowering prescriptions, verbal grievances against the plan.
- Compliance auditor at TeleTech
- TeleTech (Coach) at TeleTech
- Customer Service Representative at TeleTech
- PDP Sales at TeleTech
1 year, 4 months at this Job
The Lead Coding Compliance Auditor, is responsible for supervising the Compliance Department’s coding auditor staff and for planning the Department’s auditing activities related to physician outpatient (and some inpatient) coding, to ensure smooth and timely operations. This position is also responsible for training others on the proper use of systems to ensure accurate, timely, and efficient auditing and coding. The Lead Coding Compliance Auditor will also be heavily involved in the supervision and creation of new audit tools and processes, and the revision and ongoing improvement of existing audit tools and processes. The Lead Coding Compliance Auditor works closely with the Compliance Manager and other leadership areas to help promote and administer’compliance program and fulfill its obligations under the OIG standards.
- Lead Coding Compliance Auditor at Children's Healthcare of Atlanta
- Clinical Coding Specialist at New York Methodist Hospital
- Coding Consultant at Coders Network Corporation
- Coding Auditor at NYU Langone Medical Center
2 years, 11 months at this Job
- - Medical Coding and Billing
I currently work at Unity Health White County Medical Center as the Coding Compliance Auditor/Coding Coordinator. I oversee 16 employees in the Coding Department daily, and ensure the compliance and accuracy of coding functions.
- Coding Compliance Auditor/ Coding Coordinator at Unity Health White County Medical Center
- Team Member at Sawbucks
- Pizza Cook at Big Ben's Food and Fun
6 months at this Job
- Bachelor's - Health Information Management
Dedicated hardworking employee who is fully committed to providing the highest possible standards of quality assurance. A professional who has the aptitude to understanding Clinical Documentation Improvement, ICD-10 CM Guidelines on both inpatient and outpatient aspect, understanding of the HCC concepts and impact on Population Health Risk Adjustment reimbursement initiatives. Highly skilled in analyzing and validating patient information, diagnoses, auditing and billing data. Possess excellent understanding of current treatment practices and insurer guidelines.
clinical documentation /Auditing/Risk adjustment PROFILE
New York Presbyterian Hospital, New York, NY 2018-Present
Corporate Compliance Auditor Specialist
• Provides group and one-on-one provider education along with support staff training and mentoring to endure that Corporate Compliance staff is proficient in utilizing the standardized audit and reporting systems, tools and methodologies of the Office of Corporate Compliance
• Ensures New York Presbyterian Hospital medical documentation on prospect and retrospective reviews are compliance with applicable coding and documentation guidelines that are consistent with the Center for Medicare and Medicaid (CMS), AHIMA, Coding Clinic and other industry standards, to identify and react to incomplete or inaccurate documentation of CPT and/or ICD-10-CM.
• Communicates with providers and support staff on an ongoing basis to correct/improve documentation and coding requirements.
• Performs webex/phone and in-person provider audit feedback meeting communicate with the Providers, NP, PA and Corporate Compliance team.
• Conducts new provider orientation and billing compliance presentations to providers of all specialties
• Maintains TES edits/reports/data board and MDaudit audits software provider updates.
- Corporate Compliance Auditor Specialist at New York Presbyterian Hospital
- Clinical Documentation Improvement & Auditor Specialist at Weill Cornell Medicine
- at Gruskay Connectivity LLC Medical Staffing Company
- Compliance Auditor Specialist at IPC Hospitalist Management Consultants of NY INC
1 year at this Job
Compliance auditor, various computer programs such as MDaudit, Chartmaxx, Next-gen, perIbirth, IDX and AHS hospital billing. Audited doctors medical and billing charts of all and every specialty to make sure they were in Compliance.
- Medical Billing/Coding Compliance Auditor at Maimonides Medical Center
- Cashier/Customer Service at Pathmark
- Customer Service at Lowe's
- Customer Service at EZ-Pass
6 months at this Job
- Certificate in Medical Billing and Coding
- Associate - Liberal Arts
• Audit payroll in compliance with District Council 9 Collective Bargaining Agreement
• Efficient data entry of on-site client financial information
• Schedule audits with employees under agreement with District Council 9
• Manage multiple projects in an efficient manor with minimal supervision
• Maintain accounting systems to record all fund transactions and assist with audits
• Perform audit analysis and reporting for critical decision-making purposes
• Assist with tax filing activities during tax season
• Construct weekly reports of audit findings to be reported to the fund administrator
• Trusted for target audits on high profile employers resulting in significant findings over $100,000
- Compliance Auditor at Marshall and Moss Payroll Compliance Services
- Intern - Real Estate at Marks Paneth LLP
- Unit Clerk at John T. Mather Memorial Hospital
1 year, 9 months at this Job
- M.B.A. - Accounting
- B.B.A. - Accounting
St. Louis, MO Apr 2012 - Dec 2013 Med Record Data Compliance Auditor, Billing Auditor, payment poster, Cross-Trained to provide assistance in check-out, lab, recovery, utility, procedure's, Purchasing/Ordering, Medical Assisting, and various other duties.
- Med Record Data Compliance Auditor, Billing Auditor at Planned Parenthood
- Customer service specialist for AT&T at Convergy's
- Office manager/administrator, St Anthony's Family Medicine at St. Anthony's Medical Center
- Receptionist, surgical scheduler at Smith Surgical Services
1 year, 8 months at this Job
- - business management
- certificate - medical
- certificate - Medical Assistant
- - General
• Plans, coordinates, supervises and evaluates the work of Financial Compliance Auditors;
• Develops and implements training programs for auditing staff;
• Resolves complex auditing problems and approves changes in substantive testing criteria and alternate auditing procedures;
• Performs large and complex financial and compliance corporate audits;
• Verifies journal and ledger entries of cash receipts and check payments, purchases, expenses, payroll and trial balance to determine if generally accepted accounting principles were followed in recording transactions;
• Perform audit research to show the purpose of the audit, areas targeted for examination, type and extent of audit tests and time needed to complete the audit;
• Review and verify documentation regarding assets, net worth, liabilities, income and expenditures;
• Review the relationship of related corporations to one another (parent, subsidiary, partnerships, S corps, and LLCs) in order to determine shifting of income;
• Participates in pre-audit and post-audit conference with management, CPA's, Lawyers and employees of the audited entity;
• Identifies exceptions to generally accepted accounting principles, noncompliance with pertinent laws, regulations and contract provisions and determines any funds that may be owed to the State;
• Explain and defend audit findings at informal and formal hearings and exit conferences;
• Supervise reviews of financial statements and audit reports prepared by outside auditors or CPA's to determine the adequacy of the reports and the effect on audit findings;
• Prepares audit reports.
• Spanish Interpreter for various tax issues
- Financial Compliance Auditor - Supervisor at State of Maryland Compliance Division
- Senior Accountant at State of Maryland Compliance Division
- Staff Accountant at Global Medical
- Bilingual - Individual Income Tax Preparer (Seasonal part time position) at Liberty Tax Service
11 years at this Job
Provide external audits of community banks to verify internal controls to determine whether the polices, procedures, and internal controls developed are adequate for ensuring compliance with Anti-Money Laundering Regulations, Bank Secrecy Act, USA Patriot Act, OFAC Compliance, Consumer Regulatory Compliance and Financial Regulatory Compliance.
• Complete regulatory and risk-based audits to help community banks identify ongoing compliance issues.
• Established strong business relationships with all departments; provide ongoing guidance and assistance.
• Developed detailed work papers to provide sufficient evidence of work completed in the execution of the audit program including testing and analyzing results.
- Compliance Auditor at First National Bankers Bank
- at Citizens Bank
- Flood Review Analyst at Trust Mark National Bank
- Loan Operations Specialist at Bank Trust Mobile
1 year, 8 months at this Job
- Bachelor of Science - Business Administration