Additional Information About the RoleGreat opportunity for an experienced coder who is looking to grow in their career.
Responsibilities include writing appeals and audits.
Remote opportunity, should reside in the Greater St. Louis area.
Preferred QualificationsRole PurposeThe Compliance Partner supports the yearly Corporate Compliance Workplan and serves as a resource to departments under review by government auditors including but not limited to Medicare Audit Contractors, Supplemental Review Medical Contractors and the Office of Inspector General. This individual would be responsible to educate, promote and reinforce compliance requirements with federal and state regulations.
Responsibilities- Conducts audit of medical records and healthcare claims. This includes but not limited to review of the medical record, assessment of the documentation and charging to ensure departments are meeting billing, coding and regulatory requirements in accordance with federal and state regulations. This includes coordinating the development of departmental action plans.
- Maintains current knowledge of federal and state billing, coding and medical necessity coverage requirements.
- Designs, develops, and implements education programs for clients and staff members in the organization to improve compliance outcomes using available regulatory guidance and resources.
- Identifies potential risk, tracts issues, and recommends opportunities for continued process improvement and controls or other risk mitigation strategies.
- Conducts appeals for post-payment denials.
Minimum RequirementsEducation- Associate or Trade School Equi
ExperienceLicenses & CertificationsPreferred RequirementsEducationLicenses & Certifications- CHC
- Registered Health Info Tech
Benefits and Legal StatementBJC Total RewardsAt BJC we're committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.
- Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
- Disability insurance* paid for by BJC
- Annual 4% BJC Automatic Retirement Contribution
- 401(k) plan with BJC match
- Tuition Assistance available on first day
- BJC Institute for Learning and Development
- Health Care and Dependent Care Flexible Spending Accounts
- Paid Time Off benefit combines vacation, sick days, holidays and personal time
- Adoption assistance
To learn more, go to our Benefits Summary*Not all benefits apply to all jobs
The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.
