Assist with hotline triage and response for Medical Group/Clinic compliance questions and concerns
Navigation/connection to other support departments and collaboration within compliance team, as needed
Assist with risk assessment process and remediation for Medical Group risks
Assist with physician compensation analysis, as assigned
Research of regulatory topics related to physician/professional services, reimbursement, and program requirements
Prepare and present compliance reviews, regulatory, and educational information to audiences across the organization
Assist with monthly review of regulatory updates at federal and state levels
Prepare reports of reviews and investigations and delivers the results to Operational Leaders
Completes special compliance related projects as needed

Bachelors Degree or equivalent knowledge in Health Care Administration, Medical Coding, Health Information Management or health related field
Typically requires 5 + years of experience in a health care environment with knowledge of health care regulatory requirements and medical coding and billing experience
Strong computer, problem-solving and analytical skills, including ability to perform data mining to identify aberrant patterns that may be indicative of compliance issues or trends
Working knowledge of compliance related regulations such as coding, billing, documentation requirements, Local and National Coverage Determinations, National Comprehensive Coding Initiatives, Medicare/Medicaid billing regulations, HIPAA Privacy rule, etc.
CCS, CCS-P CPC, CHC or CRCR certification required.

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short
and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Compliance Reimbursement Consultant

Key skills