Title: Compliance Auditor Full time remot job requisition id 135122WD Job Description: Working at Yale means contributing to a better tomorrow. Whether you are a current resident of our New Haven-based community, eligible for opportunities through the New Haven Hiring Initiative, or a newcomer, interested in exploring all that Yale has to offer, your talents and contributions are welcome. Discover your opportunities at Yale! Overview Coordinate and conduct medical billing audits for the Yale Medicine Administration. Evaluate medical billing, coding and documentation for 18 clinical departments under the direction of the Compliance Officer. Provide training and feedback to physicians and departmental personnel who have responsibilities with billing activities. This opportunity is currently remote (work from home, in or outside CT) for a position located in CT. CPC required. If the candidate does not currently hold a CPC certification, it is expected to be obtained within 6 months to 1 year after hire. Required Skills and Abilities 1. Demonstrated knowledge of ICD-10 and CPT-4 coding and billing practices. 2. Ability to interpret operative and procedural reports. 3. Well-developed oral and written communication skills. 4. Strong attention to detail with the ability to analyze data. 5. Proficient in Microsoft Word, Excel, and Access. Preferred Skills and Abilities 1. CPC credentials preferred. 2. Computer skills including Epic, WEBI, Word, Excel, and Access. 3. Proven experience in healthcare auditing, Medicare and Medicaid, or related clinical field. Principal Responsibilities 1. Primary responsibility is to complete audits of departmental compliance chart reviews and to participate in audits requested by third party payors. 2. Assess provider documentation for IDC-10 and CPT-4 coding accuracy, compliance with University and government regulations. 3. Obtain and review charge documents, encounter forms, medical records and billing procedures. 4. Evaluate results, identify system control weaknesses and in conjunction with department management, develop plan of action and solutions based on audit results. 5. Participate in the implementation of corrective action changes. 6. Design and maintain accurate tracking logs, including spreadsheets, of all ongoing investigations. 7. Follow up on corrective action. Report findings to the Compliance Officer, PFS and University Auditor as needed. 8. Conduct training sessions with individual physicians and/or departments on medical billing compliance. Provide input on areas and subjects where education is needed. 9. Advise and assist in development of training materials and programs for clinical and billing staff relative to accurate coding, documentation billing and regulatory guidelines. 10. Conduct data analysis. Generate reports using Query tools to identify trends and problem areas for focus of internal audits. 11. Participate in the ongoing implementation of the Compliance Program. Knowledge of University Medical Billing Compliance Plan, operations and procedures. 12. Stay abreast of best practice coding and auditing practices and regulatory changes. Maintain CPC designation by obtaining necessary CEUs on an annual basis. Required Education and Experience Bachelor's in Health Care Management, Finance, Business or Nursing or a related field. Five years’ experience in multi-specialty group practice, academic plan or hospital or an equivalent combination of educational and experience. Job Category Professional Bargaining Unit NON Compensation Grade Administration & Operations Compensation Grade Profile Manager; Program Leader (24) Salary Range $68,000.00 - $120,500.00 Time Type Full time Duration Type Staff Work Model Remote Background Check Requirements All candidates for employment will be subject to pre-employment background screening for this position, which may include motor vehicle, DOT certification, drug testing and credit checks basedon the position description and job requirements. All offers are contingent upon the successful completion of the background check. Health Requirements Certain positions have associated health requirements based on specific job responsibilities. These may include vaccinations, tests, or examinations, as required by law, regulation, or university policy. Posting Disclaimer Salary offers are determined by a candidate’s qualifications, experience, skills, and education in relation to the position requirements, along with the role’s grade profile and current internal and external market conditions. The intent of this job description is to provide a representative summary of the essential functions that will be required of the position and should not be construed as a declaration of specific duties and responsibilities of the position. Employees will be assigned specific job-related duties throughtheir hiring department. The University is committed to basing judgments concerning the admission, education, and employment of individuals upon their qualifications and abilities and seeks to attract to its faculty, staff, and student body qualified persons from a broad range of backgrounds and perspectives. In accordance with this policy and as delineated by federal and Connecticut law, Yale does not discriminate in admissions, educational programs, or employment against any individual on account of that individual’s sex, sexual orientation, gender identity or expression, race, color, national or ethnic origin, religion, age, disability, status as a special disabled veteran, veteran of the Vietnam era or other covered veteran. Inquiries concerning Yale's Policy Against Discrimination and Harassment may be referred to the Office of Institutional Equity and Accessibility (OIEA). Note Yale University is a tobacco-free campus.

Role Description ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced USRN to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you! Roles and Responsibilities - Provide after-hours clinical support to caregivers and patients via phone - Conduct caregiver supervision calls and review patient care plans - Respond to and advise on clinical questions and concerns that arise after hours - Ensure continuity and quality of patient care through appropriate guidance and escalation - Document interactions and communicate important updates to the care team as needed - Maintain professionalism and empathy in all patient and caregiver interactions Qualifications - Registered PHRN and USRN (Must be active) - Must be an Ohio (OH) or New York (NY) license holder - With proven clinical experience (2+ Years) - Must be keen to details - Excellent verbal and written English skills - Must be residing in the Philippines - Amenable working night shift Benefits - Competitive salary and benefits - Health Insurance with free dependents* - 10%-night differential - Attendance Bonus - Paid time off - Convertible to cash leave credits - Performance Appraisal - Work-life balance - A focus on growing your career path with us - We encourage you to follow your passions and learn new skills Company Description - Strong culture and values-driven leadership - We create opportunities for you to learn and grow at any stage of your career - Continuous learning and innovation - We foster an all-inclusive environment where everyone thrives

• Provide after-hours clinical support to caregivers and patients via phone • Conduct caregiver supervision calls and review patient care plans • Respond to and advise on clinical questions and concerns that arise after hours • Ensure continuity and quality of patient care through appropriate guidance and escalation • Document interactions and communicate important updates to the care team as needed • Maintain professionalism and empathy in all patient and caregiver interactions

• Provide after-hours clinical support to caregivers and patients via phone • Conduct caregiver supervision calls and review patient care plans • Respond to and advise on clinical questions and concerns that arise after hours • Ensure continuity and quality of patient care through appropriate guidance and escalation • Document interactions and communicate important updates to the care team as needed • Maintain professionalism and empathy in all patient and caregiver interactions