Coding and Compliance Analyst

 

Description:

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The Coding & Compliance Analyst will ensure coding and billing compliance through ongoing audits and education of physicians, staff, and clinic sites. Under general supervision, using a combination of regulatory, coding, documentation and billing knowledge, the Coding & Compliance Analyst will complete scheduled audits of assigned providers at designated intervals. Manages coding and billing audits to ensure accuracy and compliance to maximize revenue collection and educate providers and coding staff. Develops strategic solutions and provides administrative direction in the areas of coding and clinical documentation improvement. Completes internal coding reviews, audits, risk assessments and education (as applicable) for physicians and staff.

The auditor will also monitor and aid in improving the quality of documentation related to the requirements to bill for services provided. The Coding & Compliance Analyst will compare clinical and financial records to ensure that the documentation provided supports the patient charges listed. The Coding & Compliance Analyst must be able to work collaboratively to help ensure the firm’s clients maintain accurate and appropriate coding and billing.

 

The ideal candidate will have extensive experience in healthcare coding and compliance, preferably in both a hospital and healthcare company setting.

 

Experience Required:

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• Qualified candidates must possess their Certification in Healthcare Compliance (CHC) from the Health Care Compliance Board of the Health Care Compliance Association (HCCA).

• Candidates must possess a Certified Professional Coder (CPC) designation or its equivalent. CPMA is a plus. Must have an understanding of physician and other “Part B” professional billing, ICD-10-CM, regulatory compliance, litigation support and/or internal auditing. MRA coding expertise also valuable.

• Minimum of five (5) years of experience with compliance and coding auditing.

• Candidates must be able to articulate proven strategies for audit processes; including but not limited to, formulating compliance work plans, formulating and implementing audit strategies, managing auditing projects and preparing audit reports of findings.

• Ability to handle multiple tasks and meet deadlines while working independently or as an active member of a team

• Project management experience that includes interacting with and presenting to both internal and external stake holders (executives, C-suite, health policy leaders, etc.)

• Strong interpersonal skills that translate into positive relationships with colleagues and clients

• Candidates must have experience working under the auspices of counsel in a work product environment.

• Qualified candidates must have experience educating providers in one-on-one and group settings.

• Demonstrated extensive knowledge of Evaluation & Management documentation and coding criteria.

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Essential Functions:

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• Conducts compliance audits of physician E/M coding and procedure documentation.

• Develops and implements policies meant to improve coding or billing operations and provides training to coding and billing staff.

• Tracks coding or billing accuracy to measure improvement.

• Develops and delivers compliance-related training sessions to providers.

• Administer a continual feedback process to providers that include coding education or changes to billing regulations.

• Conducts coding education and training for providers.

 

Education and Experience Requirements: Bachelor’s degree in healthcare field or equivalent work experience required. 5+ years of Coding Auditing/Compliance experience is preferred.

Certifications/Licenses: Candidates must possess a Certified Professional Coder (CPC) designation or its equivalent. CPMA is a plus. Must have an understanding of physician and other “Part B” professional billing, ICD-10-CM, regulatory compliance, litigation support and/or internal auditing. MRA coding expertise also valuable.

 

Acevedo Consulting Incorporated, a leading healthcare consulting firm is currently seeking a Coding & Compliance Analyst to work either as a full time employee to support the Company and its clients with all coding and compliance inquiries and initiatives.

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Acevedo Consulting Incorporated is a coding and compliance consulting firm in Delray Beach, Florida.  Founded in 2000, the firm enjoys a reputation of excellence and is privileged to be endorsed by several local and national physician and specialty organizations. 

 

Benefits:
ACI offers a challenging work environment, competitive pay and great benefits including Health Insurance, 401(K) with company match and generous Paid Time Off and Holidays. 

 

To apply, please send resume to zton@acevedoconsulting.com