Audit Coordinator

Essential Job Responsibilities:

In coordination with the Director of Revenue Cycle, and other members of management, the Audit Coordinator provides support for:

Review of Purchasing Processes and Controls

Conduct regular audits of purchasing practices to ensure compliance with organizational policies, internal controls, and regulatory requirements.

Evaluate vendor selection, purchase order approvals, and invoice processing for efficiency, cost-effectiveness, and fraud prevention.

Provide recommendations for process improvements to strengthen controls and minimize financial and compliance risks.

Review of Labor Productivity and Tracking of FTEs

Analyze workforce productivity metrics, staffing levels, and full-time equivalent (FTE) utilization across departments.

Ensure staffing aligns with operational benchmarks and organizational needs.

Identify trends or variances that may indicate inefficiencies or opportunities for improved labor allocation.

Training in Revenue Cycle Functions

Develop and deliver training programs to staff on revenue cycle processes including patient registration, insurance verification, charge capture, coding, billing, and collections.

Ensure team members understand compliance requirements, payer policies, and best practices.

Act as a resource to improve accuracy, reduce denials, and optimize reimbursement.

Coordinating Revenue Cycle Processes and Recovery Audit Contractor (RAC) Audits

Serve as the central coordinator for all RAC audits and other payer-driven reviews.

Ensure timely submission of requested documentation, maintain audit logs, and track outcomes.

Work with clinical and administrative teams to review denied claims, appeal determinations, and implement corrective actions to prevent recurrence.

Managing CMS Merit-based Incentive Payment System (MIPS)

Oversee the collection, validation, and reporting of data required under CMS's MIPS program.

Collaborate with clinicians to ensure accurate measurement of quality, cost, improvement activities, and promoting interoperability metrics.

Provide feedback and education to providers on performance scores and help drive initiatives that improve patient outcomes and reimbursement opportunities.

Auditing Prescription Monitoring Program (PMP) Data

Conduct regular audits of PMP data submissions to ensure they are accurate, timely, and complete.

Verify that prescribing and dispensing records meet federal and state reporting requirements.

Support prescribers and dispensers in leveraging PMP data to identify potential misuse, diversion, or inappropriate prescribing patterns.

Other Duties as Assigned

Provide support to internal and external auditors.

Participate in special projects to strengthen compliance and efficiency across the organization.

Stay updated on regulatory changes impacting healthcare operations and auditing functions.

Audit of Electronic Prescribing for Controlled Substances (EPCS)

Audit of Physician Extender (PE) Compliance

Targeted Probe and Educate (TPE) audits

Education:

3-5 years' experience in auditing required; 3-5 years in clinical operations preferred; orthopedic experience is highly preferred; experience in healthcare compliance preferred.

Bachelor's degree preferred; a bachelor's in healthcare administration or health care operations preferred.

Additional Requirements:

Exceptional customer service, interpersonal skills, and communication skills.

Proficiency of electronic records systems preferred. Must have strong data entry skills.

Must be able to complete tasks with a high-degree of efficiency and accuracy while working in a fast-paced environment with frequent disruptions.

Must demonstrate ability to analyze data and resolve complex problems.

Must have the ability to work independently while managing time and workload appropriately.

Must be able to build and maintain effective working relationships with employees throughout the organization. Must be able to demonstrate a strong sense of customer-focus.

Must be able to demonstrate the ability to work independently within interpretive guidelines and perform effectively in a fast-paced and constantly changing environment.

Must be able to demonstrate exceptional written and verbal communication skills.

Must have and maintain a valid Mississippi driver's license and be able to travel to various locations, as needed.

Must have the ability to meet the physical requirements necessary to successfully perform essential job duties.

Equal Opportunity Employer

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