Senior Compliance Specialist (CPC Certification)

Senior Compliance Specialist (CPC Certification)

Legal / Compliance

New York, NY

Full-Time / Regular

NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education.

Position Summary : We have an exciting opportunity to join our team as a Senior Compliance Specialist. In this role, the Senior Compliance Specialist will assist the Manager of Professional Billing Compliance in conducting inpatient and outpatient coding, billing and medical record documentation reviews in accordance with Federal, state and local regulations. Responsibilities include drafting written reports on audit findings and providing in-service training to physicians and staff

Job Responsibilities :

• Responsible for conducting audits of medical records to determine whether services provided to patients are appropriately documented and billed in accordance with Medicare, Medicaid and third party billing regulations and / or standards
• Drafts written reports that summarize medical record review findings for Manager review
• Performs assessments of new physicians to NYU Langone and provides education based on the results of the assessment. Follow-up provided as appropriate.
• Assists Manager in investigating inquiries which may relate to erroneous billing and coding of services
• Performs reviews of Medicare Pre Probe audits and provides recommendations regarding the results to FGP management
• Develops relationships with FGP Practice Managers, FGP departmental administrators, operations managers, etc. to ensure open communication between the Compliance department and the physician practices
• Works closely with the physicians and FGP practices in order to educate them as to improvements in billing and documentation practices
• Provides in-services / presentations to physicians and staff post audit, to various practices per request, and as needed
• Performs billing and / or coding research for inquiries utilizing various sources such as the Internet, Federal Register, Medicare Carriers Manual, CPT-4 and ICD-10 references, CPT Assistance, and other industry appropriate resources
• Keeps abreast of ICD-10, CPT-4, HCPCS, and CDT coding changes, compliance issues and regulations and provides communication and updates regarding changes in regulations, policies or procedures pertaining to the Compliance Program
• Assists Manager with compliance training initiatives including coordinating training classes, writing and editing compliance manuals, developing PowerPoint presentations, etc.
• Performs and participates in other related duties as required

Minimum Qualifications : To qualify you must have a Bachelors degree in Finance, Healthcare administration or related field. Minimum of 4 years of professional coding and billing experience. Certification in clinical coding is required. Strong problem solving and analytical skills. Excellent verbal and written communication skills. Proficiency in Microsoft office. Must be able to communicate with physicians, senior administrators and office staff. Epic systems and / or EHR experience.

Preferred Qualifications : Master's Degree MDAudit Enterprise experience Certification in dental coding

Qualified candidates must be able to effectively communicate with all levels of the organization. NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents. NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision.

NYU Langone Health provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $81,325.15 - $135,541.73 Annually.