Compliance and Clinical Documentation Integrity Auditor

Talkiatry transforms psychiatry with accessible, human, and responsible care. We’re a national mental health practice co-founded by a patient and a triple-board-certified psychiatrist to solve the problems both groups face in accessing and providing the highest quality treatment.    

60% of adults in the U.S. with a diagnosable mental illness go untreated every year because care is inaccessible, while 45% of clinicians are out of network with insurers because reimbursement rates are low and paperwork is unduly burdensome.   With innovative technology and a human-centered philosophy, we provide patients with the care they need—and allow psychiatrists to focus on why they got into medicine.  

About the role: 

Talkiatry is seeking a Compliance and Clinical Documentation Integrity Auditor. The successful candidate will be responsible for education and ongoing feedback to our healthcare professionals regarding correct documentation and will provide detailed recommendations to improve procedures and policies. The Auditor will be responsible for identifying incomplete documentation by examining coding procedures and ensuring the organization complies with regulatory requirements. The Auditor will also be responsible for quality oversight of our medical coding team and providing feedback to Revenue Cycle management.  

The successful candidate will be expected to identify outliers, reimbursement deficiencies, inefficiencies, incorrect codes, and poor documentation to protect the integrity and accuracy of the billing process and illuminate non-compliant billing practices. The Auditor will be responsible for day-to-day management of a team of Clinical Documentation Improvement Specialists, providing day-to-day support regarding policies and regulatory questions. The Auditor will ensure the quality and steady processing of provider feedback. This role reports directly into the Vice President of Revenue Cycle Management. 

You will: 

• Onboard and train medical staff and conduct subsequent auditing at intervals dictated by internal policy 
• Perform coding compliance audits of claims to ensure appropriateness and accuracy of code assignments in accordance with established guidelines 
• Provide ongoing analysis and feedback of the educational needs for providers and other healthcare staff 
• Mange the Clinical Documentation Integrity Specialist team (CDIS) 
• Review feedback given to providers and make recommendations for improvement. 
• Ensure daily productivity by the CDIS team meets targets and coaching team members who are falling short 
• Provide ongoing audit of CDIS output to ensure compliance with internal as well as payer-based policies and regulations 
• Ensure compliance with regulatory and payer billing requirements and charge capture process improvement 
• Become a subject matter expert on billing compliance matters and work with clinical departments to ensure that appropriate claims controls are in place. 
• Keep up to date with relevant healthcare regulations and payor-related policies. 
• Participate in and/or lead inter-departmental process improvement initiatives.  
• Perform concurrent review of claims to revise for proper documentation.  
• Analyze and review audit data to prepare reports for Chief Compliance Officer, Revenue Cycle Department, and clinical provider teams.  
• Post- review / audit education and training when applicable  
• Assist in development of internal compliance policies and standard operating procedures 

Your Qualifications:

• Bachelor’s degree in health information management or relevant field 
• Certified professional medical auditor (CPMA) ;AAPC or AHIMA certification is required 
• Understanding of critical coding concepts and medical record auditing skills 
• 3 - 5 years previous experience in healthcare revenue cycle compliance, preferably in the behavioral health setting 
• Must have extensive knowledge of E&M, CPT, HCPCS, revenue codes and ICD-10/DSM-5 coding 
• Electronic health record experience preferred 

Why Talkiatry:

• Top-notch team: we're a diverse, experienced group motivated to make a difference in mental health care  
• Collaborative environment: be part of building something from the ground up at a fast-paced startup   
• Flexible location: work where you want to, either remotely across the U.S. or from our HQ in NYC   
• Excellent benefits: medical, dental, vision, effective day 1 of employment, 401K with match, generous PTO plus paid holidays, paid parental leave, and more!  
• Grow your career with us: hone your skills and build new ones with our Learning team as Talkiatry expands   
• It all comes back to care: we’re a mental health company, and we put our team’s well-being first  
• Compensation range for this position is $80,000 to $90,000, depending on experience; actual compensation will be dependent upon the specific role, location, as well as the individual’s qualifications, experience, skills and certifications. 

At Talkiatry, we are an equal opportunity employer committed to a diverse, inclusive, and equitable workplace and candidate experience. We strive to create an environment where everyone has a sense of belonging and purpose, and where we learn from the unique experiences of those around us. 

We encourage all qualified candidates to apply regardless of race, color, ancestry, religion, national origin, sexual orientation, age, citizenship, marital or family status, disability, gender, gender identity or expression, pregnancy or caregiver status, veteran status, or any other legally protected status. 

Salary : $80,000 - $90,000