Full-Time

Compliance Manger

Updated on 12/5/2024

Medical University of South Carolina

Medical University of South Carolina

Mid

Charleston, SC, USA

Category
Risk & Compliance
Legal & Compliance
Required Skills
PowerPoint/Keynote/Slides
Requirements
  • Bachelors and 3 years’ experience or Associates Degree with 5 years’ experience required.
  • Internal candidates may be considered without a degree based on coding certification and relevant experience.
  • Experience educating physician’s in-group or individual training sessions.
  • Demonstrates solid technical knowledge, understanding of business concepts, regulatory rules and auditing procedures.
  • Experience researching coding questions and providing documentation to support coding decisions.
  • Extensive knowledge of ICD-9/10, CPT, HCPCS coding and Medical Terminology.
  • Excellent communication and interpersonal skills.
  • Must maintain credentials through education and stay current on regulatory trends and changes in the law.
  • Knowledge of Microsoft Office Applications including Word, Excel and PowerPoint.
  • Experience with and aptitude for using medical billing software.
  • Licensures, Registrations, Certifications: CPC, CCS-P, RHIT or other Medical coding certification required.
Responsibilities
  • Complete monthly audits following UMA Auditing Policy and report findings to the individual audited, the Physician Liaison, Department Administrator and Chairman on a monthly basis.
  • Perform risk-based audits, as needed to ensure compliance, based on bell curve information, OIG Work Plan issues, New Providers, Level III Providers, helpline calls or other criteria established by the CCPO, Senior Managers, Executive Compliance Committee or other party, as applicable.
  • Assist the Senior Manager & Corporate Data Manager in developing methodology for audits and reports in order to present findings in a clear concise manner.
  • Responsible for follow up audits to validate resolution of documentation issues and completion of corrective action plans.
  • Research Coding and other regulatory issues for clinicians and care team members.
  • Respond to concerns and allegations and work with CCPO or Sr. Managers to develop corrective action plans and follow up appropriate to the issues identified.
  • Assist in the development and deployment of educational/training materials and campaigns; communicates proactively extensively throughout the system to provide education on compliance matters including but not limited to coding guidelines, billing, documentation and reimbursement, Teaching Physician Regulations, and scope of practice.
  • Responsible for providing and entering all education sessions into designated system per departmental instructions.
  • Responsible for onboarding all new billing providers through one on one education within 30 days of start date.
  • Attend all Departmental Compliance meetings, department, division, clinic, or faculty meetings as requested.
  • Works closely with clinicians and EMR technical staff in providing assistance and recommendations of EHR templates and other standardized documentation formats.
  • Assist Sr. Compliance Managers and Chief Compliance and Privacy Officer on special projects and other duties assigned.
  • Collaborate with Regulatory Manager to prepare assigned area summary for Annual Compliance Report.
  • Responsible for monitoring and maintaining active and deferred charges within the work queue per departmental instructions.
Medical University of South Carolina

Medical University of South Carolina

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