A Compliance Officer or Analyst monitors internal compliance with company policies and also company compliance with local, state and federal laws. Reviews company documents, including contracts and marketing materials; communicates with employees and develops training and internal policy materials.
Demonstrates skills in customer service, communication, team building and problem solving. Demonstrates competency in all areas of hospital third party insurance billing including federal and state regulations. Demonstrates skill in proactively resolving problems, recommending, and implementing process changes. Demonstrates skill in communicating with patients, payer representatives and associates throughout the Health System. Coordinates and conducts periodic medical record audits for providers to assess compliance with coding (over/under coding, trends), billing, documentation, and payer regulations. Develops reports as directed. Reports findings to management and providers. Electronic Medical Record experience preferred Highly organized and detail oriented
Qualifications:
CPC-A required, CPC or CPC-H preferred Excellent communication skills and ability to form collaborative partnerships across all service settings. Proficient in the use of Electronic Medical Records (EMR); ability to create reports on own and interface with EMR vendor to develop reports where none currently exist Extensive knowledge RBRVS and federal, state, and other payer regulations pertaining to documentation, coding (E&M, modifiers, critical care) and billing. Ability to analyze coding and actively question and guide providers and/or Billing staff as appropriate. Strong medical terminology background Competent in Microsoft Office products (Word, Excel, Outlook, PowerPoint). Self-directed, self-starter and able to implement new program Accepts responsibility and follows through on projects and activities. Ability to assimilate new information and technologies into daily work.
Education:
CPC-A required CPC or CPC-H preferred Associates degree, preferred
Experience:
3-5 years of healthcare experience, preferred Billing Experience preferred Excellent public/patient relations and communication skills. Skills in using computers including Excel and Word required.
Pay Range:
$20.00 - $25.00/hour
Starting Pay:
Based on Experience Thompson Health is an EOE encouraging individuals with disabilities, and veterans to apply.
