Auditor - Data Analyst (47295)

Under general supervision of the Compliance Officer / Risk Manager, the Auditor/Data Analyst supports an effective compliance and quality management program by coordinating audit processes that includes reviewing, analyzing data, and preparing clear and accurate reports. This position assists in ensuring regulatory adherence, improving processes, and strengthening organizational integrity. Upholds the principles of WIHCC’s, Mission, Vision and Values Statement. Maintains confidentiality of all privileged information at all times.

This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all-inclusive.

Essential Duties & Responsibilities:

• Maintains regular attendance and punctuality.
• Maintains a current understanding of regulatory trends and changes in coding guidelines and reimbursement policies that affect WIHCC and its subsidiaries by monitoring various resources to assess regulatory changes and determine organizational impact.
• Assists in the development and updating of appropriate policies.
• Monitors billing and coding trends to ensure compliance and accuracy while supporting revenue optimization.
• Monitors AHCCCS updates affecting 638 facilities related to billing requirements and standards.
• Provides quarterly audit and compliance activity Reports to the Compliance Committee.
• Conducts annual facility-wide risk assessment and documents results.
• Identifies, analyzes, and interprets trends within complex data sets; prepares summaries, graphs, and presentations explaining key findings.
• Supports quality initiatives including PQRS, Meaningful Use, and similar programs.
• Conducts basic analysis for audits, projects and reports.
• Conducts basic statistical analyses for audits, projects and reports.
• Assists in developing coding educational plans, training materials, and resources related to the compliance program.
• Conducts compliance audits and ensures the audit project log/ system is current and accurate.
• Interacts professionally with all levels of management, while maintaining objectively and independent.
• Converts data into statistical information i.e., charts, graph, spreadsheets, run charts, etc.
• Shares information with appropriate Department or Committee.
• Handles confidential information with maturity and discretion and in compliance with all laws and regulations.
• Upholds all principles of confidentiality and patient care to the fullest extent.
• Adheres to all professional and ethical behavior standards of the healthcare industry.
• Adheres to WIHCCs Personnel Policies and Procedures, departmental policies, rules, and regulations.
• Interacts in an honest, trustworthy and dependable manner with patients, employees, visitors, and vendors.
• Possesses cultural awareness and sensitivity.
• Maintains compliance with all Human Resources requirements.
• Provides support to the Compliance/Risk Management Department as needed and required.
• Performs other duties as assigned.