Compliance Manager

1 week ago


St Louis, Missouri, United States Washington University in St. Louis Full time
Job Summary

We are seeking a highly skilled Compliance Manager to join our team at Washington University in St. Louis. The successful candidate will be responsible for ensuring compliance with regulatory requirements and maximizing revenue through effective charge capture activities.

Key Responsibilities
  • Supervise Coding Coordinators to ensure timely and accurate capture of hospital-based services.
  • Directly interact with faculty on coding, charge capture, compliance, and billing-related issues.
  • Perform compliance-related duties, including review of medical documentation, completion of physician audits, and OPBC audits.
  • Develop educational materials and conduct regular meetings with faculty to improve coding and documentation.
  • Assure staff attends scheduled training and in-services.
  • Stay up-to-date with procedures and changes affecting Medicare, Medicaid, HMO, PPO, and related healthcare operations.
  • Communicate policies and procedures to staff on billing issues to promote efficient flow of the billing process.
  • Monitor weekly charges, TES work files, MTC lists, and approve write-offs per departmental policy.
  • Ensure weekly completion of hospital missing charge lists and report physician non-compliance with divisional/departmental missing operative note policy.
  • Apply OPBC and departmental compliance guidelines to billed services.
  • Create TES and Medicode edits to reduce reductions and monitor TES work files for aging encounters.
  • Serve as compliance liaison to the WU Office of Physician Billing Compliance.
Requirements
  • Ability to recognize, analyze, and report trends through accounting and organizational skills.
  • Supervisory skills necessary.
  • Equivalent of Bachelor's degree in a related field with five plus years of experience in supervision, preferably in coding and/or compliance.
Benefits

Washington University in St. Louis offers a competitive benefits package, including up to 22 days of vacation, 10 recognized holidays, and sick time. We also offer competitive health insurance packages, a defined contribution (403(b)) Retirement Savings Plan, and wellness programs.

Eligible employees can take advantage of our free Metro transit U-Pass and forgivable home loan of up to $12,500 for closing costs and a down payment for homes in eligible neighborhoods.

We are committed to building a diverse community of individuals who are committed to contributing to an inclusive environment.



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