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Title: HOSPITAL COMPLIANCE OFFICER JFK Memorial Hospital Location: CAIndio Other Locations: The Hospital Compliance Officer is responsible for managing the ...
Title: HOSPITAL COMPLIANCE OFFICER JFK Memorial Hospital Location: CAIndio Other Locations: The Hospital Compliance Officer is responsible for managing the ...
* 3-5 years * Job Summary:The Compliance Program Manager of Coding and Billing is primarily responsible for overseeing coding and billing compliance functions for all campus hospitals, outpatient hospital based clinics and Faculty Physician Groups. This person will be responsible for 1) facilitating, implementing and working with appropriate hospital departments, UHC personnel, Physician Group Compliance Officers and Group Manager to ensure that the coding and billing components of the various entities Compliance Plans and policies and procedures remain current and that there is consistency and uniformity in the application of these compliance program policies and procedures, 2) providing education sessions on billing and coding compliance issues to any personnel, including, but not limited to physicians, coders, billers, charge posters, etc. involved in coding and billing of medical services, 3) developing coding and billing audit plans and ensuring timely completion of coding and billing audits and dissemination of audit findings, 4) developing and maintaining effective tools and methodologies to appropriately monitor coding and billing compliance. Assists the Executive Director of Compliance as necessary to meet the objectives of the Compliance Program. Performs other duties as Specifications:BA/BS degree required. Relevant experience accepted in lieu of imum three years experience required, five or more years preferred, in monitoring and auditing both hospital and physician billing and coding requirements. Experience researching and responding to complex hospital and physician billing and coding questions. Experience in researching and responding to regulatory issues and questions, preferably in an academic medical center environment. Must have a proven track record in understanding the operational impact of healthcare laws and regulations and taking appropriate action to mitigate risk posed by these regulations. May substitute the following experience in lieu of hands on compliance experience: five plus years in health information management handling projects and coding and performing quality coding review and/or five plus years in a complex physician practice office or medical center setting handling coding and billing tification as a CPC (Certified Professional Coder from the AmericanAcademyofProcedural Coders), CCS or CCS-P (Certified Coding Specialist-Physician from the American Health Information Management Association) required. Valid California Driver's License required. Excellent verbal, written and interpersonal skills required. Must possess pertinent skills with respect to preparing and delivering verbal and written presentations, including English language skills. Must communicate with diplomacy, objectivity, and professionalism and have the ability to relate to people of diverse demographic backgrounds. Ability to work independently and work calmly under pressure. Committed to continuous quality improvement in systems, processes and performance; consistently exercising a learning attitude and approach to all duties. Must be computer literate and have a good working knowledge of Microsoft Word, Excel and Access. Type at least 30 words per minute using Microsoft Word processing program, be able to prepare and sort spreadsheets using Excel, be able to utilize database management programs such as Microsoft Access to produce reports.
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