Kettering Health Network

Compliance Coord

2 months ago
Job ID
2017-7277
Job Category
Administrative/Business Support
Job Type
Full-Time
Shift
First Shift
# of Openings
1
Shift Time
Days

Overview

Are you interested in a career that will allow you to utilize your technical capabilities to analyize data and provide support and guidance for a mission driven organization?

 

Kettering Health Netowkr is looking for a Compliance Coordinator to identify and assess billing compliance, operational and financial risks within the employed physician network, Kettering Physician Network (KPN). Audit and monitor physician practices for compliance with existing policies and government regulations.  Develop compliance and education plans, policies and procedures that affect operations and assure recommendations to minimize risk are implemented timely and effectively.

Responsibilities & Requirements

Position Duties Include:

  • Conduct internal audits to review coded and abstracted data for accuracy and quality in order to ensure coding compliance for the KPN.
    • Prepare written reports of audit findings and recommendations to minimize risk
  • Performs general and targeted audits.
  • Identifies rejected claims due to coding and billing errors.
  • Assists in the development of Coding Compliance Action Plans in response to audit findings and makes recommendations as necessary.
  • Provides compliance education and training as necessary.
  • Assists in the development of the Corporate Integrity Annual Work Plan.
  • Collaborates with appropriate colleagues and KPN leaders in the development of improved capabilities in the areas of documentation, coding, and compliance.
  • Responds to questions regarding documentation, and coding issues.
  • Participates in the claims review processes.
  • Assists in the review of contracts for compliance issues.
  • Maintain in depth understanding of federal and state laws and regulations pertaining to billing and coding compliance within KPN

Job Requirements

  • Associates Degree in related field with three years revenue cycle and/or compliance experience (physician or hospital based experience) required. 
  • Experience in coding required.
  • 3 years of compliance and/or revenue cycle experience required
  • CPC-H, CPC-P, CCA or CCS Certification required
  • Knowledge of Recovery Audit Contractor Program, Conditions of Participation, and OIG Work Plan

Preferred Qualifications

  • Bachelor’s Degree preferred
  • Strong analytical, project management, report design, and organizational skills
  • Strong attention to detail with ability to multi-task

PM17

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