What are the responsibilities and job description for the Compliance Advisor position at Community Care Physicians?
Description
Our Compliance Team in Latham is hiring a full-time Compliance Advisor to join their team! This is a full time position, Monday - Friday.
Responsibilities:
Advise the Compliance Officer, physicians, and managers on CCP’s compliance with documentation and billing guidelines through detailed audit reports.
Audit and compile various documents from all specialties.
Assess potential compliance issues and formulate corrective action plans based on independent professional judgment.
Perform quantitative audits to ensure that encounters are accurately billed, and services are appropriately utilized.
Perform qualitative audits to enhance our providers’ clinical documentation and assess their understanding of applicable documentation and billing guidelines.
Report non-compliant behavior to Corporate Compliance Officer as well as senior-level management.
Design documentation and billing guidelines to further educate providers and staff.
Promote positive learning to staff and providers.
Ensure Medicare or Medicaid audits are executed properly.
Assist with creating new policies and procedures.
Understand and communicate CMS and other regulatory guidelines to providers and staff.
Provide education to providers and staff on documentation and billing guidelines.
Provide expert knowledge and education to providers and staff in areas such as ICD-10, CPT, HCPCS, CMS Guidelines, False Claims Act, Stark Law, and the Anti-Kickback Statute.
Travel to various sites to perform on-site audits and training.
Must keep current with changing regulatory guidelines/policies through self-education in areas that include, but are not limited to the Stark Law, Anti-Kickback Statute, and False Claims Act. Must be able to support the team and others by sharing and/or educating with regards to such changes.
Utilize Practice Management, Allscripts, Touch Works and other available tools to trend coding issues.
Improve reimbursement for all practices by monitoring trends by the providers and meeting on a regular basis for coding discussions.
If you are interested in this opportunity and have the desired qualifications, please Apply Now!
Annual salary range: $60,400 - $70,000
CCP salary ranges are designed to be competitive with room for professional and financial growth. Individual compensation is based on several factors unique to each candidate, such as work experience, qualifications, and skills. Some roles may also be eligible for overtime pay.
CCP’s compensation packages go far beyond just salary. The company offers a comprehensive total rewards package that includes medical, dental, vision and life insurances, paid holidays, paid time off, retirement plan, and much more in a business casual environment!
We welcome candidates who will bring diverse intellectual, gender and ethnic perspectives to Community Care Physicians.
Community Care Physicians is an Equal Opportunity Employer.
Requirements
Bachelor’s degree in a related field or the equivalent experience in the medical field.
At least 3-5 years of coding and/or medical auditing experience. Experience in a clinical setting is a plus.
Advanced coding and documentation knowledge.
Must be certified in coding with either a CCS-P, or a CPC.
While not required at the time of hire, advisor must obtain further credentials including but not limited to CPMA, CRC, and/or CDEO.
Advisor must maintain coding credentials in this position.
Expert knowledge in areas such as ICD-9, ICD-10, CPT-4, HCPCS, Modifiers, CMS documentation guidelines, False Claims Act, Stark Law, and the Anti-Kickback Statute. Ability to process Medicare requests and audit various types of documentation.
Ability to understand and convey all regulatory guidelines to the CCP community. Ability to exercise independent professional judgment when faced with various compliance issues or recommending a corrective action plan.
Ability to audit and investigate medical and billing records, compile data, and synthesize information to be able to identify potential Compliance issues.
Ability to demonstrate excellent oral and written communication skills in the English language.
Ability to effectively present information in one-on-one and small group settings to providers, office staff, and senior-level management
Our Compliance Team in Latham is hiring a full-time Compliance Advisor to join their team! This is a full time position, Monday - Friday.
Responsibilities:
Advise the Compliance Officer, physicians, and managers on CCP’s compliance with documentation and billing guidelines through detailed audit reports.
Audit and compile various documents from all specialties.
Assess potential compliance issues and formulate corrective action plans based on independent professional judgment.
Perform quantitative audits to ensure that encounters are accurately billed, and services are appropriately utilized.
Perform qualitative audits to enhance our providers’ clinical documentation and assess their understanding of applicable documentation and billing guidelines.
Report non-compliant behavior to Corporate Compliance Officer as well as senior-level management.
Design documentation and billing guidelines to further educate providers and staff.
Promote positive learning to staff and providers.
Ensure Medicare or Medicaid audits are executed properly.
Assist with creating new policies and procedures.
Understand and communicate CMS and other regulatory guidelines to providers and staff.
Provide education to providers and staff on documentation and billing guidelines.
Provide expert knowledge and education to providers and staff in areas such as ICD-10, CPT, HCPCS, CMS Guidelines, False Claims Act, Stark Law, and the Anti-Kickback Statute.
Travel to various sites to perform on-site audits and training.
Must keep current with changing regulatory guidelines/policies through self-education in areas that include, but are not limited to the Stark Law, Anti-Kickback Statute, and False Claims Act. Must be able to support the team and others by sharing and/or educating with regards to such changes.
Utilize Practice Management, Allscripts, Touch Works and other available tools to trend coding issues.
Improve reimbursement for all practices by monitoring trends by the providers and meeting on a regular basis for coding discussions.
If you are interested in this opportunity and have the desired qualifications, please Apply Now!
Annual salary range: $60,400 - $70,000
CCP salary ranges are designed to be competitive with room for professional and financial growth. Individual compensation is based on several factors unique to each candidate, such as work experience, qualifications, and skills. Some roles may also be eligible for overtime pay.
CCP’s compensation packages go far beyond just salary. The company offers a comprehensive total rewards package that includes medical, dental, vision and life insurances, paid holidays, paid time off, retirement plan, and much more in a business casual environment!
We welcome candidates who will bring diverse intellectual, gender and ethnic perspectives to Community Care Physicians.
Community Care Physicians is an Equal Opportunity Employer.
Requirements
Bachelor’s degree in a related field or the equivalent experience in the medical field.
At least 3-5 years of coding and/or medical auditing experience. Experience in a clinical setting is a plus.
Advanced coding and documentation knowledge.
Must be certified in coding with either a CCS-P, or a CPC.
While not required at the time of hire, advisor must obtain further credentials including but not limited to CPMA, CRC, and/or CDEO.
Advisor must maintain coding credentials in this position.
Expert knowledge in areas such as ICD-9, ICD-10, CPT-4, HCPCS, Modifiers, CMS documentation guidelines, False Claims Act, Stark Law, and the Anti-Kickback Statute. Ability to process Medicare requests and audit various types of documentation.
Ability to understand and convey all regulatory guidelines to the CCP community. Ability to exercise independent professional judgment when faced with various compliance issues or recommending a corrective action plan.
Ability to audit and investigate medical and billing records, compile data, and synthesize information to be able to identify potential Compliance issues.
Ability to demonstrate excellent oral and written communication skills in the English language.
Ability to effectively present information in one-on-one and small group settings to providers, office staff, and senior-level management
Salary : $60,400 - $70,000
