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Compliance Coding/Billing Manager
$93,000 - $139,800 / year
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Job Description
If you are an existing employee of South Shore Health then please apply through the internal career site.
Requisition Number:
R-21593
Facility:
LOC0006 - 780 Main Street780 Main StreetWeymouth, MA 02190
Department Name:
SHS Compliance
Status:
Full time
Budgeted Hours:
40
Shift:
Day (United States of America)
Reporting to the Vice President, Chief Compliance and Audit Officer, the Compliance Coding and Billing Manager is responsible for promoting ethical coding and billing practices across the entire spectrum of South Shore Health.
In this leadership role, the Compliance Coding and Billing Manager oversees two coding and compliance auditors and has responsibility for developing and leading activities to ensure compliance with applicable laws, regulations and standards applicable to the South Shore Health System.
The individual filling this role will serve as an expert in billing compliance related issues, offer guidance, and lead, as well as participate in, compliance investigations as required. They will coordinate all billing audit activities related to the billing compliance program.
Develops and monitors a system of routine audits and monitoring that will assure that systems and processes are functioning correctly in order to comply with applicable laws.
Compensation Pay Range:
$93,000.00 - $139,800.00
Job Responsibilities:
Monitors organization wide compliance with federal and state billing regulatory guidance.
Conducts prospective or retrospective coding and billing compliance audits.
Serves as an independent resource to clinical or operational departments on coding, documentation and regulatory guidelines.
Develops, prepares and reports compliance metrics to the Compliance Audit and Risk Committee and as needed.
Assists the Chief Compliance Officer with the development and implementation of the annual compliance risk assessment and internal work plan.
Participates in development training tools and materials.
Delivers education to providers, clinical and department staff on compliant documentation and regulatory guidelines.
Manages the Compliance audit team within the Compliance office.
Identifies trends in billing, coding and documentation errors. Recommends and monitors implementation of corrective action plans.
Develops SSH compliance policies and procedures as required.
Performs other related duties as assigned.
Job Requirements:
Minimum Education- Preferred
Bachelor's Degree
Minimum Work Experience
5 plus years
Required Certifications
CCA - Certified Coding Associate (AHIMA-American Health Information Management Assoc) or
CCS - Certified Coding Specialist (AHIMA-American Health Information Management Assoc) or
CCS-P - Certified Coding Specialist-Physician Based (AHIMA-American Health Information Management Assoc) or
CPC - Certified Professional Coder (AAPC-American Academy of Professional Coders) or
CPMA -Certified Professional Medical Auditor (AAPC-Academy of Professional Coders) or
RHIA - Registered Health Information Administrator (AHIMA-American Health Information Management Assoc)
Knowledge, Skills and Abilities required:
In depth knowledge and experience with Centers of Medicare and Medicaid Services regulatory guidance
Audit methodology
Ability to develop and effectively deliver coding/billing education to physicians and organization colleagues
Proficiency with Microsoft Office applications
Monday through Friday 8:00am- 4:30pm
Responsibilities if Required:
Education if Required:
License/Registration/Certification Requirements:
Certified Coding Associate- American Health Information Management Association (AHIMA), Certified Coding Specialist- American Health Information Management Association (AHIMA), Certified Coding Specialist- Physician Based- American Health Information Management Association (AHIMA), Certified Professional Coder (CPC)- American Academy of Professional Coders (AAPC), Certified Professional Medical Auditor (CPMA)- American Academy of Professional Coders (AAPC), Registered Health Information Administrator- American Health Information Management Association (AHIMA)
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