Senior Compliance Auditing/Monitoring Specialist | FT | Weekdays | Memphis

If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One!

We strive to be an employer of choice and establish a reputation for being a talent rich organization where Associates can grow their career caring for others. For over a century, we’ve served the health care needs of the people of Memphis and the Mid-South.

Serves as a subject matter expert for a variety of coding and billing related compliance issues. Coordinates, assists and conducts internal investigations related to coding and documentation issues as directed by the Chief Compliance Officer. Models appropriate behavior as exemplified in The Methodist Mission, Vision and Values.

Working at MLH means carrying the mission forward of caring for our community and impacting the lives of patients in every way through compassion, a deliberate focus on service expectations and a consistent thriving for excellence.

A Brief Overview
Serves as a subject matter expert for a variety of coding and billing related compliance issues. Coordinates, assists and conducts internal investigations related to coding and documentation issues as directed by the Chief Compliance Officer. Models appropriate behavior as exemplified in The Methodist Mission, Vision and Values.

What you will do

• Serves as subject matter expert and authoritative resource on interpretation and application of documentation and coding rules and regulations, and conducts enterprise risk assessments of potential and detected coding compliance deficiencies.
• Evaluates the adequacy and effectiveness of internal and operational controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to professional fee documentation, coding and billing, including federal and state regulations and guideline, CMS and other third party payor billing rules, and OIG compliance standards.
• Develops and implements provider compliance education and training program.

Education/Formal Training Requirements

• Bachelor's Degree Health Information Management
• Bachelor's Degree Healthcare Administration
• Bachelor's Degree Business Administration/Management
• Bachelor's Degree Finance

Work Experience Requirements

• 5-7 years Coding
• Combination of education and experience

Licenses and Certifications Requirements

• Certified Coding Specialist - American Health Information Management Association
• Certified Coding Specialist-Physician-based - American Health Information Management Association
• Certified Outpatient Coder (COC) American Academy of Professional Coders
• Certified Professional Coder - American Academy of Professional Coders
• Registered Health Information Administrator - American Health Information Management Association
• Registered Health Information Technician - American Health Information Management Association

Knowledge, Skills and Abilities

• Knowledge of Medicare and Medicaid documentation and coding rules and guidelines.
• Must have and understanding or develop knowledge of national and state laws and regulations including but not limited to: • False Claims Act • Physician Self-Referral (Stark) Anti-kickback statute • Health Insurance Portability Act (HIPPA) • Health Information Technology for Economic and Clinical Health (HITECH)
• Must have excellent verbal and written communication skills.
• Strong interpersonal skills and evidence of previous success in dealing with staff at all levels, including nurses, non-physician practitioners, physicians, and management.
• Strong organizational and planning skills.
• Demonstrates a high degree of personal integrity and practice ethical standards.
• Demonstrated proactiveness and ability to work independently and self-directed in managing multiple concurrent projects.
• Excellent analytical and problem solving skills.
• Advanced skills in all MS Office applications (Word, Excel, Outlook, PowerPoint).
• Ability to interpret and apply documentation and coding rules and regulations.
• Ability to demonstrate competence in performing audits, produce reports, formulate remediation or mitigation plans, and conduct follow-up audits.

Supervision Provided by this Position

• There are no supervisory or lead responsibilities assigned to this job, but this role is considered a subject matter expert in technical knowledge, which is used to guide and train associates and providers within the organization as assigned.

Physical Demands

• The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
• Must have good balance and coordination.
• The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
• The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
• The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work.

Our Associates are passionate about what they do, the service they provide and the patients they serve. We value family, team and a Power of One culture that requires commitment to the highest standards of care and unity.

Boasting one of the South's largest medical centers, Memphis blends a friendly community, a thriving and growing downtown, and a low cost of living. We see each day as a new opportunity to make a difference in the lives of the people in our community.