Billing Compliance Liaison
Billing Compliance Liaison
Title: Billing Compliance Liaison
Location: Midtown
Org Unit: Neurological Surgery
Weekly Hours: 35.00
Exemption Status: Exempt
Salary Range: $73,000.00 - $82,700.00
*As required under NYC Human Rights Law Int 1208-2018 - Salary range for this role when Hired for NYC Offices
Position Summary
Under general direction, monitors, reviews and guides the coding activities of WCM provider staff in accordance with the College's Professional Billing Compliance Plan, including Research Compliance. This position also documents findings and shares these results with physicians and department leadership. This role also manages Compliance Orientation and access to programs for both faculty and staff in all aspects of Compliance.
Job Responsibilities
- Conducts prospective and retrospective compliance documentation audits in the PO and research. Maintains integrity of electronic/hard copy files/databases. Tracks/trends results of audits. Reports statistics of Compliance Program to senior leadership.
- Analyzes physician coding patterns and other documentation utilizing electronic databases. Monitors coding and medical record documentation compliance with federal and state regulations. Educates clinical staff and providers on compliant coding.
- Manages new employee/faculty orientation and training for department billing, research, and compliance purposes. Works with applicable systems to gain appropriate access for clinicians and staff. Notifies staff of upcoming compliance training dates.
- Serves as a liaison for the CPO, IRB, JCTO, and HRC for both clinical and research compliance efforts.
- Develops and maintains a Clinical Research Compliance Program to conduct internal audits to ensure research is conducted ethically, safely, legally and in compliance with the protocol and institutional IRB policies and procedures.
- Researches and educates providers on appropriate coding for provider specialty.
- Trains as necessary on coding/documentation changes implemented internally and by insurance carriers.
- Monitors effectiveness of corrective action plans.
- Evaluates current compliance plan, makes recommendations for changes, and implements and executes new policies and procedures.
- Works with the department billing staff to ensure compliance with WCM Professional Billing Compliance Plan and adherence to appropriate coding; guides billing staff to make necessary corrections and release charges.
- Maintains up-to-date knowledge of ICD and Coding Regulations. Attends workshops, seminars and/or conferences to keep abreast of standards and best practices within the field. Disseminates information to colleagues and/or staff as appropriate.
- Identifies trends in revenue cycle activities, including payments, denials, billing, coding and/or documentation errors. Recommends actions plans to address deficiencies. Monitors implementation of corrective action plans.
Education
- Bachelor's Degree
Experience
Approximately 2-3 years of experience in medical records and/or physician billing.
Approximately 1-2 years of experience as medical coder.
Knowledge, Skills and Abilities
- Demonstrated knowledge of professional billing, including physician billing, reimbursement, and carrier relations.
- Demonstrated knowledge of third party reimbursement.
Licenses and Certifications
- Certified Professional Coder Certificate (CPC)
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