Manager of Hospital Billing Compliance

2 weeks ago

New York, United States NYU Langone Health Full time

We have an exciting opportunity to join our team as a Manager of Hospital Billing Compliance.

In this role, the successful candidate The Manager of Hospital Billing Compliance reports directly to the Associate Director of Clinical Hospital Billing Compliance. Together with the Associate Director and Director of Billing Compliance, the Manager will work to ensure that NYU Langone meets Federal and State regulatory billing requirements. The Manager is responsible for ensuring that business units have established and implemented effective operational processes that impact the accuracy of hospital billing across the organization. Further, the Manager will assist the Director with risk assessments and the development of the annual Workplan, as well as implementing the Workplan to ensure the scheduled reviews are performed in a timely manner.

Job Responsibilities:

Responsible for researching industry topics and compliance risks relevant to hospitals and providing insight and input into the annual Compliance risk assessment conducted by the Billing Compliance and Internal Audit teams. Conducts hospital billing reviews to ensure adherence to State and Federal billing regulations and/or standards.Responds to patient billing inquiries. Works closely with Associate Director and Director to investigate and address external requests and inquiries.Works closely with the business units to address any compliance-related deficiencies and improvement opportunities identified in such processes, serving as a regulatory subject matter expert and advisor on complex hospital documentation, coding and billing matters.Establishes goals and objectives for the Billing Compliance program and contribute to the development of the annual Billing Compliance work plan.Works closely with Revenue Cycle, MCIT and other departments to proactively monitor internal controls to manage, detect, and mitigate billing compliance risks.Participates in committees, workgroups and projects to collaborate on billing compliance matters and best practice strategies.Serves as a subject matter expert regarding provider coding and documentation standards, guidelines, and regulatory requirements across the organization, including coding, billing, CMS and other regulatory and/or payer changes.Manage curriculum development and assist in the delivery of the billing, coding and clinical documentation compliance educational training programs for providers and others in the organization to promote Federal and State regulatory compliance.Support the Billing Compliance team in responding to instances of suspected non-compliance and work closely with departments to resolve identified issues and implement corrective action plans.Collaborate with numerous individuals across multiple departments to promote and ensure compliance with various rules and regulations to align efforts and programs.Drafts written reports and prepare relevant supporting documentation and information as necessary for reviews, inquiries, and investigations.Performs other duties as assigned.

Minimum Qualifications:
To qualify you must have a Bachelors degree in finance, health care management or related field or equivalent combination of relevant education and experience required
Minimum of 5 years experience in a managerial position with direct experience in hospital billing regulations and requirements required.
Exceptional ability to communicate complicated and potentially concerning matters to providers, senior leaders, management, and staff.
Deep understanding of ICD-10-CM and CPT/HCPCS coding systems and processes.
Advanced knowledge of reimbursement systems and an understanding of basic principles of random sampling and statistical analysis.
Proficiency in Microsoft Office

Preferred Qualifications:
Hospital Billing experience in a large academic health care setting
Health Care Compliance Associations (HCCA) Certification in Healthcare Compliance (CHC)
FQHC billing experience
Epic systems experience

Qualified candidates must be able to effectively communicate with all levels of the organization.

NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.

NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment.

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