Facility: Westwood Campus
Department: AUDIT COMPLIANCE
Schedule: Full Time
Work among the best. We are a top 25 employer in the metro area offering a wide array of career opportunities within our organization. We have a leading reputation for patient care, medical education, research, and community service. We value and respect the talented, committed, and diverse people who make up our hospital; they are our most important strength. The hospital offers very competitive wages and an outstanding benefit package.
We currently have an opening for an Assistant Director of Billing Compliance
Assists Director with directing transaction testing requested by Internal Audit or the Compliance Officer.
Serve as the key resource for all incoming notifications regarding billing rules, regulations or regulatory issues.
Serves as the primary billing guidance resource for Hospital Patient Financial Services
Maintains a log of outstanding Medicare queries and follows queries through to completion.
Effectively uses the appropriate financial concepts and tools to direct the analysis related financial decisions that support the achievement of short and longer-term institutional objectives.
Researches billing issues related to the use of coding.
Researches billing issues related to new services.
Researches, leads and directs the implementation activities related to Hospital compliance with new electronic medical record system implementations, billing rules, regulations, laws and payor contractual requirements.
Develops and maintains billing compliance policies.
Proactively address any billing compliance issues that put the institution at financial (including lost revenue) risk. Develop and direct implementation of corrective action plans.
Develop infrastructure and facilitate implementation of Medicare and Medicaid Bulletins, Medicare Local Medicare Review Policies, Billing newsletters, and other related regulations.
Assist with the development of institutional policy related to the Hospital's Charge Description Master.
Proactively manage all aspects of the Hospital's Charge Description Master.
Directs hospital activities related to the preparation and response to Medicare notifications regarding non-compliance.
Develop, implement and direct procedures to ensure that all appropriate personnel receive billing issue notifications.
Provides recommendations to Director regarding Billing Compliance. Performs as a knowledgeable resource to Hospital departments in support of their understanding of billing and collection issues, inpatient access issues and non-managed care reimbursement issues.
Facilitate activities to ensure the institution receives appropriate reimbursement from payors, while helping to ensure compliance with applicable billing regulations.
Facilitate activities to ensure all Patient Financial Services (PFS) employees are acutely aware of and adequately trained to comply with Medicare/Medicaid billing regulations.
Develop, implement, and direct regular PFS training sessions related to Billing Compliance.
Develop, implement and subsequently direct the activities of a tool that allows appropriate managers to objectively measure staff knowledge of key compliance activities.
Complies with Medicare/Medicaid rules and regulations.
Serve as key Hospital resource for Medicare and Medicaid compliance issues
Demonstrates knowledge of the mainframe systems, Epic pathways, Excel and Word.
Maintains a high level of involvement in the day to day activities of areas of responsibility. Provides leadership presence and guidance through direction and role modeling.
Maintains an Open Issues Log and reviews with the Director and other Management staff to secure needed assistance in resolving issues and to promote accountability.
Attends and actively participates in any training or education, which relates to their position and would contribute to their knowledge.
High School Diploma or equivalent required
Bachelor's Degree in Business required; Master's Degree Preferred
Demonstrated ability to interpret, analyze, develop, direct and implement action to comply with proposed or final Medicare regulations
Four years of experience in Hospital Revenue Cycle environment
Demonstrated advanced PC skills
Demonstrated knowledge of Hospital Charging procedures
Demonstrated knowledge of Medicare coding rules and regulations
Demonstrated knowledge and history of compliance with payor audits
Ability to communicate clearly and use good judgement
Ability to work under stress with frequent interruptions
Ability to maintain confidentiality with patient and employee information
*** If selected to move forward in the hiring process, you will receive an email invitation to schedule your interview for this position. Please continue to check your email after you have submitted your complete application online.
To check the status of your application, please login to the Careers page and select the Application History tab ***
Browse by Job Family
“I’m truly blessed to work for an organization that values its employees, places importance on collaboration and provides a positive environment with a strong sense of camaraderie. I can’t imagine working anywhere else.”
Manager, Physician Relations Program