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Compliance Specialist
2 months ago
Minimum Hiring Wage:
From $52,291.20 a year
Job Details:
Scheduled Hours: Monday - Friday, days
Occasional travel to Fort Madison and Mt. Pleasant campuses
Job Description:
Works with providers and other staff to improve the overall quality, compliance, completeness, and accuracy of medical record documentation for facility and professional encounters. Reviews, develops, and/or modifies procedures, systems, and protocols to achieve and maintain compatibility with GRHS billing requirements and compliance standards.
Performs coding audits and other projects related to professional and facility coding compliance. Conducts routine audits for accuracy of coding and sufficiency of associated provider documentation to maintain compliance standards. Completes audit assignments and other projects in fulfillment of ethics and compliance work plans. Educates physicians and other staff members on proper coding and documentation standards and rules. Demonstrates a thorough understanding of complex coding, reimbursement, and auditing principles as they relate to hospital, physician practice, clinic, and hospital-based clinic settings. Communicates with department leadership, physicians and other staff regarding complex coding and auditing issues and current coding regulations.
Prepares reports of audit findings and meets with providers to provide education and training on compliance with documentation and coding requirements. Researches, analyzes, and responds to inquiries regarding coding concerns and related issues. Interacts extensively with physicians and other patient care providers regarding documentation and coding policies, procedures and regulations.
Trains, instructs, and/or provides technical support to medical providers and coders/coding leadership regarding coding compliance and documentation, regulatory provisions, and third-party requirements.
Assist with full chart reviews, compliance investigations, and risk analysis (outliers, benchmarks, etc.) Attends coding conferences, workshops, and in-house related meetings (i.e. FCC, Revenue Integrity, Compliance, etc.) to receive updated coding information and changes in coding and/or regulations. Collaborates with Compliance and Revenue Cycle leadership to determine documentation opportunities, educational priorities, and ensure regulatory compliance.
Qualifications:
- Graduate of Health Information Technology program or related degree
- Three to Five years’ experience billing/coding using ICD -9/ICD-10 and CPT codes in a medical clinic, physician’s office, or health system
- Certified coder with one of the following credentials: RHIA, RHIT, CPC, COC
- Certified Professional Medical Auditor (CPMA), Certified Healthcare Chart Auditor (CHCA) or equivalent certification required after two years of employment
- Strong computer experience/knowledge
- Good working knowledge of medical terminology
- Knowledge of laws, government regulations, CMS and agency rules
Benefits:
We are excited to offer an aggressive compensation and benefits package for qualifying positions, which includes:
- Competitive base pay
- Matching retirement programs
- Health, Dental and Vision plans
- Health Savings and Flexible Spending Accounts
- Employee discounts including car rental, cell-phone plans
- Employer-paid, Long-Term Disability, Life, and AD&D
- Paid time off (PTO)
- Education Assistance Program
- Employee Assistance Program
- Employee Referral Bonus Program
- Discounted cafeteria meals
- Paid Parental Leave
- Employee Service Recognition program
- Voluntary plans including: Life, AD&D, Short-Term Disability, Critical Illness, Accident, Insurance, and Hospital Indemnity
Great River Health and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
