North Highlands CA 95660
I aim to secure a Compliance Auditor position within a growing company in which I can utilize my training and skills.
Highlights of Qualifications:
- Remarkable experience in audit planning and finance researching reimbursement
- Comprehensive knowledge of Medicare and Medicaid regulations, billing, coding and documentation
- Profound ability to develop data requirements and work with Compliance Analyst and other analytical groups to extract, organize and analyze coded data
- Excellent computer skills with sound knowledge of Word and Excel
- Amazing ability to maintain confidentiality of physician, patient and sensitive information
- Familiarity with multiple reimbursement systems and healthcare regulations
- Superior analytical skills with ability to work independently
- Excellent interpersonal, and written and oral communication skills
Compliance Auditor, August 2005 – Present
UnitedHealth Group, Boise, ID
- Collaborated with the business operations leadership and personnel throughout the audit process.
- Applied identified requirements to business operations when developing and conducting compliance audits.
- Managed multiple audits and collaborated across multiple business segments.
- Developed and presented reports and results of audits.
- Coordinated with Legal Counsel as needed.
- Ensured to keep abreast on all Medicare Parts C & D regulations, guidance documents and bulletins.
Compliance Auditor, May 2000 – July 2005
Kaiser Permanente, Boise, ID
- Identified coding risk areas, & ensured that the medical center training activities are addressing appropriate areas.
- Collaborated with Compliance Analyst and workgroups and identified audit movement and risk factors.
- Identified operational audits & regulatory issues.
- Supervised coding performance.
- Prepared and performed regional & medical center auditing analysis.
- Ensured compliance of operational procedures.
Bachelor’s Degree in Health Services Administration, Thomas Edison State College, Trenton, NJ