ABOUT YITRO

In the business of connecting Excellence. As your partners, we represent you professionally throughout your growth cycle. Our deep expertise allows us to negotiate great value for our client organization.

The very crux of our business model is to manage the resourcing needs of an organization through a trusted partner. A partner who takes complete ownership of all open items and drive them to closure. Our business models bring credible & dependable solutions. We strive to earn the trust of our customers through our commitment and result-driven approach.

Global experience in spearheading Program Transitions in a Build, Operate and Manage/ Transfer model for our International clients, helping them set up their MANAGED CAPTIVES in no time. Specialized in TURN KEY projects, We also provide the flexibility for our clients to choose from an a la carte of services. Starting from Site Selection services, Leadership Hiring, Talent Acquisition, Operation Management, Revenue Management, General Management till the clients are comfortable to take over. We manage all of these and get the revenue kicking in a TURN KEY project in about 45 to 60 days upon signing the SOW.   

At the crux of the team, we bring collective centuries of leadership experience working for some of the top Global services / Product organizations & OEM’s. 

We have experience in setting up turnkey projects across India, the Philippines, China, Australia, Dubai, UK, Poland, Ireland, USA. 

With a seasoned team that has catered to the world's top Networking, Telecom & Application development captives, and OEM's in setting up their key teams in India and other locations, we will be a strong extended, embedded COE for all your offshoring needs.

yitrobc

<div><strong>JOB TITLE: </strong></div><div>Compliance Auditor</div><div><strong>NUMBER OF OPENINGS: </strong></div><div>Two</div><div><strong>JOB SUMMARY: </strong></div><div>The Compliance Auditor is responsible for planning and conducting audits of company's clinical and administrative processes, including coding and billing.</div><div>compliance, documentation, medical necessity, adherence to internal policies, procedures and</div><div>guidelines, services provided by outside vendors including company's revenue cycle vendor, and</div><div>compliance with state and federal regulations including HIPAA Privacy and Security. The</div><div>Compliance Auditor is responsible for preparing and submitting written audit reports that include</div><div>findings and recommendations, communicating findings to the Director, developing and</div><div>implementing corrective action plans when necessary, and following up to ensure that corrective</div><div>plans are implemented and were effective. <strong> </strong></div><div><strong>JOB RESPONSIBILITIES: </strong></div><div><strong>Implement the Audit Process </strong></div><div>Plan and schedule audits, including identifying the audit subject and purpose, defining audit</div><div>objective(s), defining audit scope, performing pre-audit planning, and notification to the</div><div>area(s) to be audited.</div><div>Conduct audits, including meeting with impacted employees and keeping impacted</div><div>organizational areas(s) apprised along the way of any findings and urgent actions to be taken</div><div>if necessary.</div><div>Develop audit reports that includes findings, recommendations designed to correct any</div><div>potential weaknesses or areas of noncompliance discovered during the audit, request for</div><div>management response to each finding or recommendation including corrective action plan(s)</div><div>to be developed and implemented.</div><div>Provide follow-up prior to closing the audit including confirming successful implementation</div><div>of corrective action plans, verify that management responses are implemented, and assess</div><div>new processes, procedures and actions.</div><div><strong>Stay Abreast of Applicable Regulatory Changes </strong></div><div>Maintain current knowledge of medical documentation, fraud, abuse, and documentation and</div><div>coding violations based on governmental guidelines, including State and Federal</div><div>overpayment regulations.</div><div>Stay abreast of and maintain current knowledge of Medicare and Medicaid guidelines.</div><div>applicable to company's Pain Management Clinics and Ambulatory Surgical Centers (ASCs),</div><div>including applicable Local Coverage Determinations (LCDs).</div><div>Maintain current knowledge of requirements and guidance required in the performance of</div><div>audit duties, including but not limited to ICD-10, HCPCS, and CPT coding, modifiers, and</div><div>surgical procedures documentation requirements.</div><div>Maintain current knowledge of HIPAA Privacy and Security Requirements.</div><div><strong>Conduct Audits </strong></div><div>Review medical records to determine the medical necessity of services billed and the</div><div>accuracy of coding, billing, and supporting clinical documentation in either an Ambulatory</div><div>Surgical Center (ASC) or a Pain Management Clinic.</div><div>Review records that have been reviewed and coded by the revenue cycle vendor.</div><div>Review company's practices, procedures, and materials for compliance with CMS and HIPAA</div><div>regulations.</div><div>Prepare audit reports of findings and observations that identify, in detail, areas of non-</div><div>compliance and risk areas for non-compliance.</div><div>Ensure corrective actions are implemented and effective.</div><div>Conduct other audits as assigned, including but not limited to contract reviews, lease</div><div>agreements, compliance with contract language, etc.</div><div>Share departmental responsibilities as assigned.</div><div><strong>JOB REQUIREMENTS: </strong></div><div>Bachelor s degree in accounting, business administration, or healthcare related field required.</div><div>AAPC Certified Professional Coder (CPC ) or AHIMA Certified Coding Specialist-</div><div>Physician-based (CCS-P) certification, required.</div><div>Certified Professional Medical Auditor (CPMA) certification preferred.</div><div>Healthcare compliance certification, a plus.</div><div>A strong understanding of healthcare regulations, such as HIPAA, Medicare, Medicaid, and</div><div>other relevant industry standards, is essential.</div><div>Solid grasp of auditing principles, techniques, and methodologies.</div><div>Experience working autonomously.</div><div>Healthcare auditing, billing/coding experience, required.</div><div>A minimum of 5 years experience in a healthcare compliance.</div><div><strong>KNOWLEDGE, SKILLS AND ABILITIES: </strong></div><div>Knowledge of federal (including HIPAA) and state regulatory requirements.</div><div>Strong analytical and critical thinking skills.</div><div>Attention to detail and the ability to think strategically.</div><div>Excellent written and verbal communication skills to present findings and results effectively.</div><div>Ability to work well in a team, contribute effectively, and manage priorities.</div><div>Good computer software skills and knowledge.</div><div>Knowledge of data analysis and audit software tools is a plus.</div><div><strong>HOURS AND WORKING CONDITIONS: </strong></div><div><strong>Work from Office, Timings- 1pm -10 pm </strong></div><div>Our corporate office is located in Tampa, FL. This job may require travel to company's locations.</div><div>throughout Florida, Texas, and California.</div><div><em>Please note this job description is not designed to cover or contain a comprehensive listing of activities, </em></div><div><em>duties or responsibilities that are required of the employee for this job. Duties, responsibilities and </em></div><div><em>activities may change at any time with or without notice. </em></div><div><em>__________________________________________________________________________ </em></div><div>Employee s Printed name Date</div><div>___________________________________________________________________________</div><div>Employee s Signature Date<em> </em></div>