Healthcare Compliance Analyst overseeing regulatory compliance initiatives for Bronson Healthcare Group. Requires analytical skills and extensive coding experience.
Responsibilities
Oversees the regulatory compliance for physicians employed by Bronson Healthcare Group as well as, all nursing floors and ancillary departments within the Bronson Hospitals.
Coordinates the implementation, monitoring and enforcement of compliance initiatives for Bronson Healthcare Group, to comply with applicable laws and regulations as they relate to billing procedures and requirements.
Reviews the billing, documentation and coding practices of all BHG employed physicians as part of the Corporate Compliance Program and make the necessary changes to ensure the bills are compliant and to minimize the exposure to monetary penalties.
Reviews the billing, documentation and coding practices for all Bronson Healthcare Group facility departments as part of the Corporate Compliance Program and make the necessary changes to ensure the bills are compliant and to minimize the exposure to monetary penalties.
Responds to questions, issues and reports of potential issues in coordination with compliance officer.
Independently assesses critiques and makes authoritative recommendations for revisions to physician’s and hospital coding and documentation techniques and policies.
Monitors such on an ongoing basis and ensures that approved recommendations are implemented.
Assists with training and education related to corporate compliance to physicians and hospital departments.
Interacts frequently with the Corporate Compliance Officer and is an active member of the Billing Compliance Committee.
Participates in yearly OIG Audit Plan by auditing and reviewing any Bronson Healthcare Group risk factors.
As requested, participates with any third party (MPRO, BlueShield/BlueCross, Medicare, Medicaid) audit for the hospital or hospital employed physicians.
Requirements
Bachelor’s degree or equivalent combination of education and experience
2-3 years of extensive coding experience required
Certification as a Certified Professional Coder (CPC) OR Registered Health Information Technician (RHIT) preferred or must obtain within 6 months of hire.
Extensive coding background in healthcare is needed
Strong analytical skills required to monitor and direct regulatory monitoring
Must have proven organizational and planning skills as well as the ability to handle multiple tasks simultaneously
Requires excellent communication skills and a positive customer relation’s orientation
Effective interpersonal skills required to interface between medical staff, managers and Directors, internal billing and administrative staffs or external vendors and to initiate corrective action, as necessary
Effective public speaking skills and the ability to articulate complex regulatory information in understandable, layman’s terms is necessary
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