• Validate the accuracy of CPT, HCPCS, revenue codes, and billed line-item charges on outpatient and inpatient facility claims. • Review medical records and supporting documentation to confirm that billed services, supplies, and items are appropriately documented and billed accurately. • Apply CMS guidance, coding guidelines, MUE/NCCI edits, industry standards, and policies during claim review. • Perform itemized bill reviews, including validation of revenue code line items and supporting documentation. • Conduct hospital bill audits to evaluate billed line charges and identify potential coding, billing, or documentation issues. • Assess medical necessity as part of claim review activities. • Prepare appeal responses using applicable coding guidance, industry standards, and company/client policies. • Assist with new concept development and claim selection criteria.

Role Description The Senior Internal Auditor is responsible for planning, coordination and completion of internal audits and Sarbanes-Oxley 404 requirements. You will help complete risk assessments to establish the annual internal audit plan, preparing internal audit reports for review by the Internal Audit Manager, performing special projects and ad hoc assignments. Technical auditing and accounting skills and 3+ years of experience with GAAP is required. As our Senior Internal Auditor, you will report to the Internal Audit Manager. On a given day, you may: - Evaluate risk areas and provide important input on the development of the Audit Plan. - Lead audit procedures, identify issues, develop criteria and analyze evidence. - Complete the financial, Sarbanes-Oxley and information technology-based audit engagements. - Lead effort to maintain the internal audit programs and policies and develop new audit programs. - Provide or help provide training and guidance to Internal Audit seniors and staff in conducting audits and other audit-related issues. - Experience with data analytics and use of tools such as Tableau and Microsoft BI. Qualifications - Bachelor's Degree in Accounting. - 3+ years of relevant accounting/auditing experience; public accounting and/or internal auditing at a manufacturing company. - Knowledge of and skill in applying internal auditing, GAAP and accounting principles and practices. - Oversee and motivate engagement team members and engage with all levels of management. - Manage multiple field audit assignments and special projects. - Readiness to accept additional responsibilities, and willingness to try new ideas and methodologies. - You must be authorized to work in the US without sponsorship now or in the future. Requirements - The estimated annual salary range for this role is $90,000 - $110,000 annually. Please note the salary information shown above is a general guideline only. Starting salary will vary by location, qualifications, and prior experience. - Travel up to 30% of the time, including international assignments. Benefits - Medical, Dental, life insurance, short-term and long-term disability, family leave, vision coverage, and a matched 401(k) plan.

• Support and execute operational and/or compliance audits, advisory projects, and SOX/C-SOX assessment • Support Internal Audit Managers in business partnerships and risk assessment • Coordinate with business process owners and external auditors • Manage audit project phases: planning, execution, issue escalation, remediation verification • Contribute to data analysis and documentation of audit findings • Ensure compliance with internal audit standards • Collaborate with Internal Control and external auditors for SOX/C-SOX compliance • Support advisory engagements and special projects to enhance internal audit function

Role Description Audits medical record documentation and coding to extract data and determine appropriate ICD-10-CM/PCS and HCPCS codes for billing, internal and external reporting, and compliance with the Official Coding Guidelines for Coding and Reporting, payer regulations, and hospital policy. Educates physicians and clinical personnel to ensure complete documentation in the medical record and queries physicians to resolve incomplete or conflicting information to ensure compliant coding and billing practices. Educates and trains coders to ensure both a working knowledge of coding and reimbursement guidelines and successful career ladder completion, including the development of training materials and reference documents. Researches audit results, error reports, and denials and resolves by successful appeal, staff education, and correction of discrepancies. Qualifications - 4 year / Bachelor's Degree in Health Information Management or related medical degree (Required) - In lieu of a Bachelor's Degree; an Associate Degree and a Minimum of 4 years additional relevant experience is acceptable. - 4 - 5 years Experience with ICD-9, ICD-10, and HCPCS coding including hospital inpatient medical records (Required) - 4 - 5 years Extensive knowledge of medical terminology, pathophysiology, and pharmacology (Required) - 4 - 5 years Experience calculating and analyzing MS-DRG, DRG, APC, and other payer reimbursement methodologies (Required) Requirements - Adheres to the hospital and departmental attendance and punctuality guidelines - Performs all job responsibilities in alignment with the core values, mission and vision of the organization - Performs other duties as required and completes all job functions as per departmental policies and procedures - Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs) - Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time. Benefits - General environment: Works in a well-lighted, air-conditioned area, with moderate noise levels. - May be required to change from one task to another of different nature without loss of efficiency or composure. - Periods of high stress and fluctuating workloads may occur. - May be scheduled as needed including overtime. Certifications and Licensures - Required Certifications/Licensures: Certified Coding Specialist (CCS) - Preferred Certifications/Licensures: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), AHIMA Approved ICD-10 Trainer General Skills - Organizational Skills - Communication Skills - Interpersonal Skills - Customer Relations - Mathematical - Analytical - Grammar / Spelling - Read / Comprehend Written Instructions - Follow Verbal Instructions - Basic Computer Skills - Microsoft Office Suite - General Clerical Skills Physical Requirements - Have near normal vision - Clarity of vision (both near and far), ability to distinguish colors - Ability to perform - repetitive tasks/motion Physical Demands - Standing - Occasionally within shift (1-33%) - Walking - Occasionally within shift (1-33%) - Sitting - Continuously within shift (67-100%) - Bending/Stooping - Occasionally within shift (1-33%) - Twist at waist - Occasionally within shift (1-33%) - Pushing/Pulling - Occasionally within shift (1-33%) - Reaching above shoulder - Occasionally within shift (1-33%)