Sr. Compliance Coordinator- Billing & Coding

About the position Responsibilities • Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services identified as part of the review for specialty providers or upon request from management. • Interacts with specialty providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation based on the review. • Develops and/or presents educational training material to specialty providers and coders based on findings and trends identified as a result of the reviews; provides general education on coding and documentation rules and regulations, regulatory provisions, and third party payer requirements to new employees and providers to include Employee and Provider New Employee Orientation. • Interacts with government agencies/contractors, management, employees and others, as necessary, to ensure an understanding of the organization’s compliance initiatives. • Conducts and coordinates routinely scheduled reviews of BJCMG specialty providers' documentation involved with professional fee billing for accuracy of coding and physical presence; reviews consist of ambulatory E&M services and office procedures, as well as hospital admissions, subsequent visits, hospital procedures, and all other services performed by BJCMG specialty providers; reviews medical record documentation to identify under-coded and up-coded services, prepares reports of findings, and meets with providers to provide education and training on accurate coding practices and compliance issues; serves as subject matter expert related to specialty coding. • Conducts focused reviews across the BJCMG enterprise based upon the Compliance Department's annual work plan and/or trends identified based upon internal reviews or requests from senior leadership; performs special projects as requested/assigned by management; monitors trends across the organization and develops education and training on accurate coding practices and compliance issues. • Provides guidance and serves as mentor to fellow coordinators related to the audit process, coding, billing and compliance; identifies and notifies management educational opportunities and/or concerns as a result of serving as lead auditor. • Support the HIPAA liaison by tracking and conducting employee investigations when requested. Requirements • High School Diploma or GED • 5-10 years of experience • CCS/CPC certification Nice-to-haves • Associate's Degree in Business/Healthcare Administration or related field • RHIA/RHIT certification Benefits • Comprehensive medical, dental, vision, life insurance, and legal services available first day of the month after hire date • Disability insurance paid for by BJC • Pension Plan/403(b) Plan funded by BJC • 401(k) plan with BJC match • Tuition Assistance available on first day • BJC Institute for Learning and Development • Health Care and Dependent Care Flexible Spending Accounts • Paid Time Off benefit combines vacation, sick days, holidays and personal time • Adoption assistance Apply tot his job Apply To this Job