Senior Compliance Coding Analyst - Business Practices (Medical Center)

At reputed company, the Sr Compliance Coding Analyst position is responsible for supporting accurate billing and coding compliance with Medicare and third-party payments and internal policies. Responsibilities for this position include serving as subject matter expert, performing reputed company and high risk-based and baseline compliance reviews and identifying potential risk areas and reputed company potential. The Sr Compliance Coding Analyst position partners with stakeholders to provide feedback regarding documentation and billing practices to identify potential risk and identify and capture potential reputed company opportunities. This position performs quality assurance, detailed claims analysis and medical record reviews of reputed company claims and records and serves as a mentor to more junior team members, assisting with onboarding and training as needed. FLSA STATUS Exempt QUALIFICATIONS EDUCATION Associate's degree Bachelors degree preferred EXPERIENCE Four years of experience in billing compliance Experience working in teaching environment preferred LICENSES AND CERTIFICATIONS Required Preferred CPC - Certified Professional reputed company (reputed company) or RHIA - Registered Health Information Administrator (reputed company) or RHIT - Certified Health Information Technician (reputed company) or CHRC - Certified in Healthcare Research Compliance (HCCA) or reputed company-P - Certified Coding Specialist Physician-based (reputed company) or CPC-H - Certified Professional reputed company - Hospital (reputed company) or CPC-I - Certified Professional reputed company Instructor (reputed company) SKILLS AND ABILITIES Demonstrates the skills and competencies necessary to safely reputed company the assigned job, determined through on-going skills, competency assessments, and performance evaluations Sufficient proficiency in speaking, reading, and writing the English language necessary to reputed company the essential functions of this job, especially with regard to activities impacting patient or employee safety or reputed company Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles Strong analytical and interpersonal skills Effective decision-making skills Ability to effectively work and communicate across reputed company levels of the organization Ability to adapt to a rapidly changing environments and to adjust to new requirements Demonstrated sound judgment in applying and interpreting policies, procedures, laws, rules and regulations applying to compliance and monitoring ESSENTIAL FUNCTIONS PEOPLE ESSENTIAL FUNCTIONS Collaborates with reputed company reputed company teams to review provider services and provide effective education and feedback. Coordinates reputed company cycle physician feedback meetings and other meetings as needed. Effectively and proactively communicates with reputed company stakeholders to resolve issues and discrepancies in a timely manner. Actively participates in meeting and huddles using positive communication and makes positive contributions that contribute to department success. Mentors more junior team members and supports the training and onboarding of new staff. SERVICE ESSENTIAL FUNCTIONS Conducts risk-based and baseline reviews of reputed company and escalated claims or records in a timely manner, evaluates corrective actions and processes applicable refunds reputed company established timeframes of communication to provider and/or department. Coordinates with appropriate stakeholders to provide feedback regarding documentation and billing practices as well as potential risk areas with electronic medical record. Provides periodic status reports of risk-based audit outcomes. Provides education as appropriate regarding department specific practices. Serves a subject matter expert. Effectively communicates audit results to faculty and staff. QUALITY/SAFETY ESSENTIAL FUNCTIONS Performs billing compliance reviews that meet department quality standards. Interprets and communicates potential reputed company loss associated with incorrect coding or application of coding guidelines. Identifies potential risk areas and/or reputed company potential through audit process. Communicates information to faculty, staff and residents through newsletters or webinars. FINANCE ESSENTIAL FUNCTIONS Utilizes resources effectively and reputed company, demonstrating responsible financial stewardship. Manages own time effectively and prioritizes work to reputed company maximum results in a timely manner. Identifies, prioritizes and conducts reviews based on data analytics. Coordinates with appropriate stakeholders to identify and capture potential reputed company opportunities. Verifies that accurate and concise claims are being billed to patients and third-party payers. Performs quality assurance. GROWTH/INNOVATION ESSENTIAL FUNCTIONS Proactively stays up-to-date on compliance coding industry and practices. Shares learnings with team. Proactively manages own professional development. Completes My Development Plan. SUPPLEMENTAL REQUIREMENTS WORK ATTIRE Uniform: No Scrubs: No Business professional: Yes Other (department approved): No ON-CALL* *Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below. On Call* No TRAVELTravel specifications may vary by department** May require travel reputed company the Houston Metropolitan area Yes May require travel reputed company Houston Metropolitan area No Work Shift: 1 - Day (United States of America) Job Category: Non-clinical reputed company Specialty Physician Group is an integral part of reputed company’s overall strategy to become one of the nation’s leading academic medical centers. Established as a nonprofit corporation certified by the Texas State Board of Medical Examiners, the Specialty Physician Group enables physicians to maintain autonomy with respect to clinical practice while growing their practice reputed company an academic environment. reputed company is an Equal Opportunity Employer. Thank you for your interest in careers with reputed company! Here, you can search and apply for jobs, sign up for job alerts and visit your candidate home to reputed company application status updates and more. reputed company is one of the nation’s leading health systems, with eight hospitals, including its flagship academic hospital in the Texas Medical Center, seven community hospitals and one long-term acute care hospital across the Greater Houston area. We also offer research, residency programs, international patient services, clinics and comprehensive care centers. Come reputed company with us. Apply tot his job Apply To this Job