Compliance Specialist

5 days ago


New York, New York, United States LMHS Full time
Job Summary

We are seeking a highly skilled Compliance Specialist to join our team at Licking Memorial Health Systems (LMHS). As a Compliance Specialist, you will play a critical role in ensuring the accuracy and compliance of our billing and coding practices.

Key Responsibilities
  • Review and analyze patient accounts that are pended due to system edits or payer denials.
  • Maintain a comprehensive Corporate Compliance Audit Schedule.
  • Stay up-to-date on regulatory requirements related to coding and billing.
  • Complete the Corporate Compliance dashboard on a monthly basis.
  • Participate actively in committees and compliance meetings with individual departments throughout the organization.
  • Identify organizational risk through trend analysis of errors and edits.
  • Focus on the compliance of physician corporation coding and documentation practices.
Requirements
  • Minimum 3-5 years of hospital billing experience, with Certified Coding Specialist (CCS) certification preferred.
  • Comprehensive knowledge of billing and coding requirements for Medicare, Medicaid, and other third-party payers.
Preferred Qualifications
  • 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.
About LMHS

Licking Memorial Health Systems is a leading, non-profit healthcare organization dedicated to improving the health and well-being of our community. We are committed to diversity, equity, and inclusion, ensuring that every member of our community is served with respect and compassion.



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