City/State
Norfolk, VAWork Shift
First (Days)Overview:
Compliance Coding AuditorPerforms a number of functions including those of physician education, internal auditing, coder education, management of AR queries/problems, and liaison with external auditors for corporate audits. The internal audit program assures optimal ethical reimbursement for Sentara's patients, and also assures that the coding practices fall within established compliance guidelines.
Both ICD and CPT coding methodologies are used in the internal audit activity. The Auditor must exhibit competence in Correct Coding Initiative (CCI), National Coverage Determination (NCD), Hierarchical Conditionals Categories (HCC) and other federal payer policies, and is expected to achieve mastery in the MPFS payment methodology, including the impact on Relative Value Unit (RVU) value related to Non-Physician Practitioner (NPP) services, Provider Based Billing (PBB) locations, and all other complex coding protocols within one year.
All queries arising from the audit process are managed by the Compliance Auditor. Follows audit plan, completing numerous audits and providing follow-up to coders, management, and physicians. Looks for new problem areas, trends, etc., and advises Manager of Audit and Coding Compliance. Works with leadership regarding scheduling of internal and external audits.
Education
Associate Level degree preferred but required
Certification/Licensure
CPC or CCS certification (Required)
Experience
4+ years of experience with multi-specialty coding (Required)
4+ years of experience with acute care outpatient coding (Required)
Professional fee coding experience (Required)
Remote work opportunity preferred candidates in the Virginia/North Carolina geographic location
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Skills Required
- Associate Level degree
- CPC or CCS certification
- 4+ years of experience with multi-specialty coding
- 4+ years of experience with acute care outpatient coding
- Professional fee coding experience
Sentara Healthcare Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Sentara Healthcare and has not been reviewed or approved by Sentara Healthcare.
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Parental & Family Support — Four weeks of paid parental leave at full base pay and two weeks of job‑protected family caregiver leave support major life and care needs. Emergency back‑up care and reimbursements for infertility, adoption, and surrogacy further bolster family support.
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Retirement Support — A 401(A) plan alongside 403(B)/401(K) employer matching is designed to strengthen long‑term financial security. Company‑paid life insurance with buy‑up options adds additional protection for families.
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Flexible Benefits — Choice of medical plan designs and dental/vision options enables tailoring coverage to individual needs. An annual election between tuition assistance and student‑loan repayment offers flexibility to align with financial or education priorities.
Sentara Healthcare Insights
What We Do
Sentara Healthcare celebrates a 130-year history of innovation, compassion and community benefit. Based in Norfolk, VA, Sentara is a diverse not-for-profit family of 12 hospitals, an array of integrated services and a team of nearly 30,000 strong on a mission to improve health every day. This mandate is pursued through a disciplined strategy to achieve Top 10% performance in key measures through shared best practices, transformation of primary care through clinical integration and strategic growth that adds value to the communities we serve in Virginia and North Carolina.
