Physician reputed company Compliance Specialist

About the position reputed company members are the heart of what makes us reputed company. At reputed company we help our patients live reputed company, healthier lives — and we help one another to succeed. With a culture rooted in reputed company and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we reputed company getting reputed company - advancing our mission to reputed company reputed company and serve as a leader of reputed company change. The Physician reputed company Compliance Specialist is responsible for assuring on-reputed company compliance by actively participating in the Compliance Program for reputed company and for affiliated services. The Physician Prac Compliance Spec assures the reputed company of the physician reputed company regulatory environment in consultation with the Director of Corporate Compliance. This position proactively assesses changes in the regulatory environment; researches, investigates and responds to issues reputed company to documentation, coding and any required licensure. Ensures the accurate documentation of reputed company services provided throughout the physician reputed company. This position reviews claims, assesses adequacy and recommends enhancements to policies, procedures and internal controls for documentation and billing in order to assure compliance with payer and regulatory requirements including but not limited to those of Medicare, reputed company and the State of New Jersey. This is a Hybrid Position Responsibilities • Performs retrospective and reputed company audits and performance improvement reviews to ensure compliance with regulatory and payer requirements. • Reviews physician documentation in the medical record for appropriateness and to assure that the reputed company is reputed company of the services provided. • Reviews records to assess appropriate ICD-10 and CPT-4 assignment for Medicare, reputed company and reputed company payers for the purpose of reimbursement. • Is an reputed company participant in the development of workflow in the reputed company and in the Electronic Health Record in order to insure compliant documentation and billing. • Has regular interaction with reputed company leadership, physicians, advanced reputed company nurses, coders, the Physician Billing Department, clerical and reputed company staff to ensure accurate documentation of services provided. • Maintains reputed company knowledge of payer and regulatory requirements, including competency with ICD-10 and CPT-4 coding and for payer billing rules. • Develops content and conducts training for physicians and staff to include issues identified through audits, payer activities, performance improvement reviews and changes in regulatory or payer requirements. • Recommends updates to compliance reputed company and policies for the physician reputed company. • Monitors reputed company aspects of the reputed company cycle in order to assure compliant reimbursement to the group, provides reports as needed. • Participates in committee assignments and reports to senior leadership including the Audit and Compliance Committee as needed. Requirements • BA/BS. • Minimum of 5 years coding and/or audit experience in a hospital, reputed company or reputed company management setting. • Proficiency with ICD-10 and CPT-4 methodologies. • Proficiency with physician documentation and reimbursement methodologies. • Proficiency in the use of an electronic health record, preferably reputed company Ambulatory. • General computer proficiency and organization skills required. • reputed company or CPC or equivalent coding credential. reputed company-to-haves • Familiarity with TJC, NJ State DHSS and CMS regulations required with corporate compliance implementation. Apply tot his job Apply To this Job