Job Description

Duties/Responsibilities:

• Develop and implement organizational compliance policies and regulations.
• Oversee business operations related to compliance, including billing, coding, and documentation standards.
• Design and monitor internal control systems to prevent and address violations of legal and policy requirements.
• Conduct regular assessments and audits of processes to identify risks, inefficiencies, and areas for improvement.
• Collaborate with department managers to align and update compliance policies across all units.
• Lead training sessions for staff and providers on compliance, coding regulations, and documentation best practices.
• Analyze coding trends to improve accuracy, reimbursement, and data quality.
• Manage coding workload distribution and ensure timely completion of provider clarification queries.
• Facilitate communication among coders, providers, and nurses to address documentation gaps and reflect severity of illness accurately.
• Ensure clinical documentation complies with federal regulations and organizational standards.
• Conducts research and performs administrative duties
• Takes continuing education courses and stays up to date on changes in laws governing coding and clinical documentation
• Performs other duties as assigned

Required Skills/Abilities:

• Strong knowledge of ICD-10, CPT, and HCPCS coding systems.
• Strong analytical and problem-solving abilities.
• In-depth knowledge of the latest procedures and regulations.

Education & Experience:

• Degree in Health Information Management, Healthcare Administration, or a related field preferred.
• Certification as a Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent.
• 2 years of compliance/auditing experience is required.
• Experience in a multi-specialty clinic setting preferred.
• Prior experience with Endoscopy coding preferred.