Compliance Coordinator

2 weeks ago

Newark, United States LMHS Full time
LMHS COMPLIANCE COORDINATOR

Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare organization, passionately dedicated to improving the health and well-being of our community.With a history dating back to 1898, LMHS remains a cornerstone of healthcare excellence, catering to the evolving needs of Licking County. Our cutting-edge facility provides a comprehensive spectrum of patient care services, from life-saving emergency medicine to the comforting embrace of home healthcare, with a unique range of specialized medical services, including cancer, heart health, maternity, and mental wellness.

When you join the LMHS team, you become a vital part of your local community Hospital.Working at LMHS is not just a job, it is a unique opportunity to directly impact the health and well-being of your friends, family, and neighbors.You will be providing care in a place in which you are personally connected, where the impact of your work extends beyond the Hospital doors and into the heart of our community.Our commitment to diversity, equity, and inclusion ensures that every member of our community is served with respect and compassion.Join us in our mission - dedicated to patient safety, utilizing state-of-the-art technology, and with a passionate team of highly trained and compassionate individuals who strive to improve the health of the community.

Position Description

Under the general direction of the Compliance Audit Supervisor, this position is primarily responsible for review of system claim edits prior to billing to ensure appropriate CPT codes and modifiers are applied to the services provided.

Responsibilities

  • Review and analyze patient accounts that are pended due to system edits or payer denials.
  • Maintain Corporate Compliance Audit Schedule.
  • Keeps abreast of appropriate regulatory requirements related to coding and billing.
  • Monthly completion of the Corporate Compliance dashboard.
  • Active participation in committees and compliance meetings with individual departments throughout the organization.
  • Identifies organizational risk through trend analysis of errors and edits.
  • Primary focus on the compliance of the physician corporation coding and documentation practices.
Requirements
  • Billing experience required with a minimum of 3 - 5 years of hospital billing experience. Certified Coding Specialist preferred.
  • Work requires a comprehensive knowledge of billing and coding requirements for Medicare, Medicaid and other third-party payers.
  • Understanding of compliance, payer rules related to billing for supplies and services, and use of modifiers for billing purposes.
  • Organizational and administrative skills with meticulous attention to detail.
  • Ability to work independently with minimal supervision.
  • Possesses flexibility and willingness to handle a variety of tasks.
  • Proficient computer skills, including Microsoft suite and electronic health record systems.
  • Well-developed written and verbal communication skills.
  • Not a remote position.


Licking Memorial Health Systems is an equal opportunity employer and maintains compliance with all state, federal, and local regulations.Licking Memorial Health Systems does not discriminate against applicants because of race, color, religion, sex, sexual orientation, age, ancestry, national origin, veteran status, pregnancy, disability, marital status, or other characteristics protected by law.

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