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Job Description:
The Director, Healthcare Compliance Audit & Education leads Alpine’s compliance program with a focus on auditing and monitoring of coding and billing activities and related clinical education.
Essential Functions:
In collaboration and partnership with the Chief Compliance Officer:
- Design and oversee the Compliance Auditing & Education Program, utilizing data to detect, mitigate, and monitor risks associated with coding, billing or documentation
- Evaluate the effectiveness of existing controls and develops audit and education plans to focus on, and prioritize high risk areas
- Create and deliver educational materials to a variety of audiences including healthcare providers, medical coders and billers on coding standards, billing practices, and compliance requirements
- Provide guidance and direction to ensure successful execution of audit plans
- Develop and deliver reports to the Board of Directors, executive management and leadership
- Oversee external audit activities of the company’s internal coding and billing processes
- Independently investigate compliance related matters, document processes and findings, oversee the corrective action process
- Develop, communicate, and execute policies and initiatives to promote awareness and understanding of compliance issues, applicable laws and regulations, requirements, and consequence on non-compliance
- Maintain confidentiality and ensures compliance with HIPAA regulations
- Other duties as assigned
Knowledge, Skills and Abilities:
- Demonstrated ability to effectively collaborate with multiple teams across the organization
- Ability to generate and encourage creative ideas, innovative thinking and imaginative solutions to issues or problems related to compliance
- Stays abreast of the current regulatory environment of health care, (multiple) State & Federal requirements, ethics, and pertinent legislation
- Thorough knowledge of third party payer requirements, specifically Medicare
- Skilled in managing projects and deadlines
- Excellent verbal and written communication skills
- Great customer service skills
- Great teamwork and leadership skills
- Independent problem-solving skills
- Self-motivated and self-managed
- Proficient in Microsoft Office Suite
Qualifications:
- Bachelor’s degree in health, business administration or related field
- Certified Professional Coder and Professional Auditor, required
- Certified in Healthcare Compliance, preferred
- Minimum 5 years of experience working within a broad variety of healthcare settings:
- Auditing in healthcare billing and coding
- Working with regulations and translating into operational procedures
- Leading teams and/or leading healthcare programs
- Managing multiple critical deliverables simultaneously
- Strong knowledge of ICD-10, CPT, HCPCS, coding systems
- Home office that is HIPAA compliant for all remote or telecommuting positions as outlined by the company policies and procedures
Salary Range:
$93,225.60 - $135,000