Compliance Analyst II

1 week ago

Bala Cynwyd, United States Penn Medicine Full time
Job Summary

Penn Medicine is committed to delivering exceptional patient care, advancing medical research, and educating future healthcare leaders. As a Hospital Compliance Analyst II, you will play a critical role in ensuring compliance with federal and state coding and billing regulations.

Key Responsibilities
  • Perform focused APC audits to assess the adequacy of medical record documentation and ensure compliance with ICD-10-CM diagnosis and CPT/HCPCS procedure codes.
  • Conduct focused documentation reviews in response to internal/external allegations and apply knowledge of Medicare Outpatient Prospective Payment System guidelines to confirm accurate reimbursement.
  • Assist in research and development of annual Compliance audit plans and participate in special reviews, investigations, and external audits.
  • Prepare analysis of audit results, including formal reports of findings and recommendations for corrective action.
  • Develop and deliver billing compliance education sessions for staff, including case studies and examples of correct coding and revenue risk/opportunities.
Requirements
  • Certified Coding Specialist (CCS), Certified Procedural Coder (CPC), Certified Outpatient Coder (COC), or Certified Inpatient Coder (CIC) certification at time of hire.
  • 6+ years of experience in a related field, including outpatient hospital coding, APC analysis, auditing, billing, and statistical analysis.
  • Knowledge of medical terminology, human anatomy, and physiology.
  • ICD-10-CM/PCS and CPT/HCPCS coding/billing experience.
What We Offer

Penn Medicine is committed to providing a comprehensive compensation and benefits package, including one of the finest prepaid tuition assistance programs in the region. We believe that the best care for our patients starts with the best care for our employees.

We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran, or any other status protected by applicable law.

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