Compliance Analyst

  • Job ID:

    3742

  • Pay rate range:

    $40/hr - $50/hr

  • City:

    San Diego

  • State:

    California

  • Duration:

    04/24/2022 - 07/24/2022

  • Job Type:

    Contract

  • Job Description:

    Compliance Analyst

    • Pay: $40 to $50/hour

    • Start Date: 4/25/2022

    • Contract Length: 3+ months

    • Location:  Remote

    A Midsize Health Systems Company is seeking a Compliance Analyst to oversee all inpatient coding investigations, inquiries and correspondence as needed from key stakeholders.

    Responsibilities of the Compliance Analyst:

    • Assist with all inpatient coding related audits and reviews

    • Review electronic health records to identify potential coding and billing compliance issues

    • Evaluate the quality of clinical documentation and monitor the appropriateness of queries with the goal of improving physician documentation through physician education and feedback as well as achieve accurate coding to support the optimal allowable reimbursement

    • Compile all findings and recommendations in a summary report and facilitates communication to key stakeholders

    • Support the development of the Company's standardized documentation, medical necessity, coding and billing policies and guidelines and other educational materials and ensuring they complement the official coding rules and guidelines, CMS' beneficiary coverage rules and Federal/State rules and regulations

    • Analyze and assess the Company's Compliance Department billing and coding risk assessment data, MDAudit risk analyzer software, OIG Work plan, CMS, PEPPER Reports, RAC Denials, Industry Experts, etc.

    • Analyze the Company's hospital inpatient data and review patterns and trends and identify potential risk areas

    Requirements for the Compliance Analyst:

    • 5+ years of Inpatient coding and documentation auditing or active coding experience is required in the following coding systems: ICD-10-CM/PCS, DRG, CPT&HCPCS, and/or E/M CPT

    • Bachelor's degree required, preferred BS in Nursing or Medical School Graduate, or related

    • Certification and high level of experience with coding in ICD-10-CM & ICD-10 PCS and CPT coding classification is required

    • AHIMA’s Certified Coding Specialist (CCS) or Certified Documentation Improvement Practitioner (CDIP) or AAPC Certified Inpatient Hospital/Facility (CIC) certification is required

    • Certified in Healthcare Compliance (CHC) is preferred

    • AHIMA Approved ICD-10 CM/PCS Trainer preferred

    •  Knowledgeable of Centers for Medicare and Medicaid (CMS) or all applicable Federal and State statutes, regulations, and program guidelines related to inpatient and outpatient revenue integrity compliance guidelines

    • Revenue Integrity Experience or Compliance Reimbursement Auditor Experience required

    • Excellent written and verbal communication skills

    • Experience in training physicians preferred

    • Preferred experience using 3M HDM, 3M 360, MD Audit, and Electronic Medical Record-Cerner and Epic

    #PCFA #Healthcare #LI-REMOTE

    About PeopleCaddie 

    PeopleCaddie is a digital talent marketplace focused exclusively on contract opportunities for highly-skilled business professionals. Our talent cloud utilizes proprietary data and technology to help contractors find attractive job opportunities through PeopleCaddie’s user-friendly mobile app while enjoying unparalleled visibility in pay rates and application status.

    With an established array of clients nationwide, including Fortune 500 companies spanning multiple industries, PeopleCaddie has quickly become one of the fastest-growing talent clouds. 

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