Senior Coding Compliance Analyst

4 weeks ago

Peosta, Iowa, United States Trinity Health Full time
Employment Type:
Full timeShift:

Job Overview:

KEY RESPONSIBILITIES:
  • Deliver training and support on coding and billing principles and regulations, aligned with the Corporate Compliance Plan, to physicians, management, clinical personnel, coding teams, and insurance representatives.
  • Collaborate with the Director of Patient Accounts to pinpoint opportunities for process enhancements within the procedure coding domain. Engage in regular discussions with the Director to assess and refine processes from billing to reimbursement.
  • Inform management and clinical teams about changes in billing processes. Ensure that relevant staff have the necessary access and understanding of billing and compliance regulations.
  • Guarantee adherence to Medicare and other payer regulations, as well as the Corporate Compliance Plan. Facilitate and coordinate education on billing compliance. Assist in compliance evaluation activities under the guidance of the Corporate Compliance Officer. Address compliance issues and contribute to corrective action plans with the Corporate Compliance Officer.
  • Offer expertise in CPT/ICD coding and billing to the practice across all billing aspects; implement changes in billing practices in response to regulatory updates and reimbursement guidelines.
  • Serve as the team leader for all procedure billing personnel, providing education, resources, and evaluations of billing practices. Support the manager in staff development, problem resolution, and assessment of operational efficiencies.
  • Execute assigned procedure coding tasks, including the application of CPT and ICD codes and their entry into PM software for billing purposes.
  • Regularly reconcile scheduled case lists with billed procedures.
  • Act as a liaison between billing and insurance teams. Provide billing education to insurance personnel to ensure accurate and timely billing and reimbursement processes.
ADDITIONAL RESPONSIBILITIES:
  • Perform related duties as necessary.
REQUIRED QUALIFICATIONS:

Proficient in computer keyboard operations. A minimum of 7 years of experience in coding and billing is essential. ACS-CA, CPC-Cardio, and/or CPC-CTS certification is required or must be obtained within one year of employment.

A High School diploma or GED equivalent is mandatory.

Our Commitment to Diversity and Inclusion

Trinity Health stands as one of the largest not-for-profit, Catholic healthcare systems in the country. Grounded in our Mission and Core Values, we prioritize diversity, equity, and inclusion in all our endeavors. Our workforce is enriched by varied experiences, customs, abilities, and talents. Together, we strive to achieve our fullest potential. A diverse and inclusive workforce ensures the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified candidates will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

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