Healthcare Compliance Manager

Lewisville, NC 27023

Posted: 12/03/2019 Employment Type: DirectHire Industry: Management Job Number: 96228

Job Description

The Resource is hiring a Healthcare Billing Compliance Manager for our client, a medical billing company located in Lewisville, NC! This permanent, Direct Hire opportunity offers a competitive salary, and has a day shift working schedule. Interested candidates must be able to work flexible, extended hours to support business needs, as well as have the ability to travel. Responsibilities for this role include ensuring company-wide knowledge, adherence, and compliance with healthcare billing & privacy laws and regulations. Qualified candidates must have strong communication skills, and knowledge of CMS guidelines that are applicable to state, local, and federal laws & regulations. If you have previous medical billing experience and are seeking a new opportunity, apply today!

- Conduct Internal Compliance Investigations and Reviews throughout the billing process and provide detailed recommendations to Compliance Officer and Management
- Manage team responsible for Quality Assurance Process, track, analyze and communicate the results of audit process to leaders and develop process improvements based on audit results
- Identify needs and opportunities to improve compliance initiatives; develop and communicate policies & procedures as needed for successful implementation
- Serve as ongoing resource to all departments and all locations for Compliance related inquiries
- Assist management in process improvements and monitor these improvements for consistent implementation
- Coordinate, manage, and communicate reviews between internal staff, clients, and external parties as necessary to ensure alignment and timely response
- Coordinate Internal Response to all Government, Payor, and Client Initiated Audits, communicate findings to internal staff, conduct appeals to Payor as necessary
- Maintain up-to-date knowledge of all relevant billing & privacy laws and regulations and communicate internally as appropriate
- Develop Educational Materials and Conduct Ongoing Compliance Training and develop written communications for distribution to external clients as regulations are updated
- Investigate, respond to, and Communicate response to all Compliance Related Inquiries in a timely manner
- Collaborate with other internal staff to identify appropriate corrective actions when problems arise to not only address the problem but also prevent further occurrences
- Participate in company-sponsored events and industry-related conferences, trade shows, etc.

Required Education, Skills, & Experience
- Bachelors degree in healthcare, business, or related field with at least 3 years of direct experience in healthcare compliance & reimbursements or 6+ years of direct experience in healthcare compliance & reimbursements
- Strong, demonstrated knowledge of all aspects of healthcare compliance and demonstrated understanding of medical billing cycle and payor rules and regulations
- Strong decision-making, problem-solving, critical thinking, and analytical skills with the ability to identify the cause and effect of problems and determine appropriate next steps/corrective action
- Ability to develop effective educational materials and train others to achieve results and strong collaboration skills
- Willing and able to travel, sometimes on short notice, to various business sites, conferences, etc
- Strong sense of confidentiality and professionalism regarding medical and financial information
- Highly organized with the ability to manage time, prioritize work effectively, and remain productive amid frequent interruptions
- Excellent oral and written communication skills, facilitation skills, and presentation skills
- Ability to effectively manage multiple projects and tasks at a time and meet deadlines
- Proficiency in Microsoft Word, Excel, Outlook, and Power Point; High level of accuracy and attention to detail

Preferred Education, Skills, & Experience
- Healthcare compliance certification strongly preferred; Legal background a plus
- Clinical healthcare experience (paramedic, RN, etc.)
- Prior experience in EMS industry and/or ambulance billing
- Prior experience in communications or public relations role and experience auditing the work of others and/or establishing operational processes and procedures

Submit your resume online or email directly to jyeargan@theresource.Com to be considered for this position. For more information, call 336-970-5214.
While we appreciate all inquiries, only qualified candidates will be contacted for further information.
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