Manager Compliance - Physician Services

Plans and implements key initiatives for the compliance program related to physicians, advance providers, coding, billing, and reimbursement. Identifies/Investigates potential compliance concerns and provides compliance guidance and education to operational staff related to professional coding, billing, documentation, and reimbursement activities. Responsible for contributing to the development of the Biannual Compliance risk assessment and work plan as it pertains to physician services issues.

Supervises the daily work of Compliance Analysts and serves as team leader for physician compliance‐related investigations as delegated by the System Director Compliance Audit & Investigation. Requirements

Bachelors required; Master’s preferred.

3 years’ experience in healthcare coding, billing, reimbursement required. 3 years’ experience in compliance preferred. Certification: CPC (Certified Professional Coder) required. Compliance certification (CHC) required.

License: N/A Other: Ability to work effectively and collaboratively with others at any level of leadership. Possess appropriate, professional judgment to plan and accomplish goals. Ability to perform a wide variety of tasks.

Possess resilience and flexibility to perform in a fast-paced (internal and external) environment of growth and change. Extensive knowledge of various compliance rules and regulations in the professional coding, billing, and reimbursement areas. Extensive knowledge of the various payment concepts including ICD-10, CPT, and managed care capitated arrangements.

Extensive knowledge of electronic medical record (EPIC) for review of compliance with professional coding, billing, and reimbursement. Ability to participate with upper management in a decision support role through the development of appropriate management information. Ability to effectively coordinate the activities of outside consultants, at times under the attorney-client privilege and work product doctrine.

Ability to supervise and lead teams toward the accomplishment of goals. Possess skill in using Microsoft office for analysis and report generation. US:FL:Fort Myers