Provides research, analysis and recommendations regarding the organization's compliance with regulatory/statutory requirements affecting patient billing and accounting practices. Responsibilities: Maintains current knowledge of regulations and statutes regarding patient billing and accounting practices. Researches questions related to the organization's compliance and provides recommendations.| Conducts regular bill audits. Coordinates Medicare and other regulatory reviews/audits. Provides recommendations to management based on audit results.| Monitors key compliance measures and develops corrective action plans based on analysis.| Ensures all claims are submitted in accordance with CCI guidelines by assisting Medicare billers with research, correction and processing of any claim not passing CCI edits. Make recommendations for solutions to prevent recurrence of errors.| Analyzes data to identify likely relationships, summarizes data and prepares summary materials for discussion with clinical and finance teams.| Designs and refines reporting that provides insight for process improvement operations.
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Health care
