Sr. Coding Compliance Analyst Remote

Summit Health Remote
compliance analyst remote compliance health management tools summit team data manager medical analysis
January 13, 2023
Summit Health
Union City, New Jersey
Career Opportunities at Summit Health and CityMDSummit Health and CityMD form a physician-driven, patient-centric network, committed to simplifying the complexities of health care and bringing a more connected kind of care.
Our unique network was created by the 2019 merger between Summit Medical Group, one of the nation's premier independent multispecialty medical groups, and CityMD, the leading urgent care provider in the New York metropolitan area.
Together, Summit Health and CityMD deliver a more intuitive, comprehensive, and responsive care experience for every patient, regardless of the stage of life or health condition, through high-quality primary, specialty, and urgent care.We are continually growing to meet the needs of our patients and deliver exceptional care to an even greater population.
Summit Health now has more than 2,800 providers across more than 80 specialty areas, 13,000 employees, and over 370 locations in New York, New Jersey, Connecticut, Pennsylvania, and Central Oregon.
CityMD has over 150 locations across the tri-state.
We share a vision of improving the way health care needs are addressed by offering timely, high-quality, comprehensive care with an exceptional patient experience.
Together, we provide the best possible care to every patient in every neighborhood.Join our team! Summit Health and CityMD are dedicated to hiring and retaining the right talent who will contribute to our ongoing expansion and success.
We work to set clear goals and expectations, while regularly managing performance and cultivating personal and team capabilities within a positive, collaborative environment that recognizes and rewards success.
We strive to make each team member's experience at our company inspiring.
Explore our open positions and apply to become a part of the Summit Health and CityMD family. The Senior Coding Compliance Analyst must exhibit an understanding of coding concepts, AMA, CMS/OIG/Federal/State regulations & guidelines, benchmark standards and must have a high level of analytical and statistical skill sets in order to monitor the systems for data quality and integrity across the various functional applications.The Senior Coding Compliance Analyst is responsible to maintain the department dashboard, as outlined in Organization's compliance plan, along with project management of department initiatives associated with the Coding Compliance Educational Services Team.
This position is also responsible for tracking/monitoring areas of potential risk and escalating areas of concern to the Manager and Director.
Additionally the Senior Analyst is responsible for the Department's maintenance and data integrity of electronic files/reference tools, along with routine reporting (weekly and/or monthly) reporting of Provider's compliance with new coding educational initiatives and baseline reviews.Essential Job functions:
Coding Compliance Project Management - Educational Services Team:
Assists Manger with project management of special projects as assigned and coordinating tasks with co-workers as needed.Develops, maintains and implements tracking and reporting mechanisms related to compliance initiatives and activitiesResponsible to create department specialty and individual Provider presentations, documentation tools and other reference toolsUnder the direction of the Manager, manages the Auditor's workflow, custom rules, coordination of medical records that are needed for audits, ensures timely complementation of projects, educational reviews, baseline reviews, etc.Data collection management of annual baseline audit reviews (400+ Providers) as outlined in organization Compliance Plan.
Coordination of records as needed for audit reviews, logging of scores and communication via secure link(s).Coordination of process for correcting claims accordingly based on final audit review, releasing only compliant claims for billing and management other claims that require additional review.Coding Compliance Risk and Baseline Assessments/Dashboard:
Development and management of baseline audit review - Coding Compliance dashboard.Applies knowledge of ethical coding principles and revenue cycle activities to evaluate coding compliance with processes, potential areas of risk and/or areas of needed education.Utilizes practice management system and other system applications to run reports on payer claim activity and other identified organizational areas of potential risk and exposure.Utilizes a risk-based audit approach and establishes preliminary scope of reviews, incorporates data-mining and analysis where appropriate and alerting the Manager and/or Director of any areas of concern.Compliance Educational Initiative Tracking/Report Analysis:
Runs reports for Coding Compliance Department, Management Team and physicians as needed to communicate data of interest, work performed or ad hoc.Exhibits strong research skills including knowledge of automated analysis tools and online research tools to conduct research on assigned issues.Produces weekly and monthly reports to report status of Coding Compliance projects/initiatives and Provider compliance.Prepare written reports of analysis and audit findings along with bell curves, graphs, etc.
in order to present to Manager, Director, Physicians or other parties.Ability to audit, abstract code medical record for proper assignment of diagnoses and procedure codes, E&M level according to AMA, ICD-9-CM, CPT, CMS and OIG Guidelines.Conducts audit reviews related to Coding Compliance initiatives and communicates/collaborates with Manager and other teams regarding audit outcomes and educational areas of opportunity.Data Integrity/Reference Material:
Responsible for the review of the new provider/practice acquisitions existing coding tools for accuracy and re-creation of tools to ensure they meet organizational compliance standardsResponsible for the electronic maintenance of Provider reference tools, ensuring we have the most up to date tools that meet "best practice standards" and annual coding updates.Responsible for maintenance of Coding Compliance Educational Service's "library" both electronic and hard copy references ensuring most up to date versions.Manages the creation and implementation of reimbursement and compliance related processes that may affect various disciplines of the organization to ensure accurate billing, compliance and reimbursementGeneral Job functions:
Other duties as required.Physical Job Requirements:
Endurance to work long hours on projects and educational initiatives.Education, Certification, Computer and Training Requirements:
Associate' degree required.
Bachelor's Degree preferred.2 years experience required.
Previous supervising experience preferred.Proficient use of Microsoft Office Applications (Excel, Access, and Word) required.Medical Coding Certificate CPC, CCS-P, CCA or RHIT required.
Auditing, Compliance and Billing or Practice Management Certifications - CEMC, CPCO, CPMA, CCP-P, CHC, CPPM, etc.
preferredAbility to multi-task, organize & prioritize work within any given setting required.Ability to process a large amount and various types of data required.Ability to work with diverse personalities required.Experience using standard office equipment (Phone, Fax, Copy Machine, Scanner, and Email/Voice Mail) preferred.Experience using standard office technology in a Window based environment required.Total Rewards at Summit Health CityMDOur team members are essential to our mission to.

Report this job

Similar jobs near me