[Remote] Sr. Compliance Coordinator-Billing & Coding

Note: The job is a remote job and is open to candidates in USA. BJC Medical Group is a multi-specialty physician-led organization of BJC HealthCare, providing access to extraordinary care across the Midwest. The Senior Compliance Coordinator conducts reviews of specialty provider documentation to ensure billing accuracy and develops educational opportunities on compliance and coding regulations for providers.

Responsibilities

• Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services identified as part of the review for specialty providers or up on request from management
• Interacts with specialty providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation based on the review
• Develops and/or presents educational training material to specialty providers and coders based on findings and trends identified as a result of the reviews; provides general education on coding and documentation rules and regulations, regulatory provisions, and third party payer requirements to new employees and providers to include Employee and Provider New Employee Orientation
• Interacts with government agencies/contractors, management, employees and others, as necessary, to ensure an understanding of the organization’s compliance initiatives
• Conducts and coordinates routinely scheduled reviews of BJCMG specialty providers' documentation involved with professional fee billing for accuracy of coding and physical presence; reviews consist of ambulatory E&M services and office procedures, as well as hospital admissions, subsequent visits, hospital procedures, and all other services performed by BJCMG specialty providers; reviews medical record documentation to identify under-coded and up-coded services, prepares reports of findings, and meets with providers to provide education and training on accurate coding practices and compliance issues; serves as subject matter expert related to specialty coding
• Conducts focused reviews across the BJCMG enterprise based upon the Compliance Department's annual work plan and/or trends identified based upon internal reviews or requests from senior leadership; performs special projects as requested/assigned by management; monitors trends across the organization and develops education and training on accurate coding practices and compliance issues
• Provides guidance and serves as mentor to fellow coordinators related to the audit process, coding, billing and compliance; identifies and notifies management educational opportunities and/or concerns as a result of serving as lead auditor
• Support the HIPAA liaison by tracking and conducting employee investigations when requested

Skills

• High School Diploma or GED
• 5-10 years of experience
• CCS/CPC certification
• Experience with analyzing provider data and training on current billing guidelines to identify trends
• Previous auditing experience of evaluation and management and surgical procedures
• Working knowledge of EXCEL and MS Publisher
• Associate's Degree
• Business/HC Admin/related
• RHIA/RHIT certification

Benefits

• Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
• Disability insurance

paid for by BJC

• Annual 4% BJC Automatic Retirement Contribution
• 401(k) plan with BJC match
• Tuition Assistance available on first day
• BJC Institute for Learning and Development
• Health Care and Dependent Care Flexible Spending Accounts
• Paid Time Off benefit combines vacation, sick days, holidays and personal time
• Adoption assistance

Company Overview

• The BJC Medical Group wants to be an outstanding physician-led company that provides exceptional medical care. It was founded in 1993, and is headquartered in St Louis, Missouri, USA, with a workforce of 1001-5000 employees. Its website is https://www.bjcmedicalgroup.org.

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