Job Description
This position will work closely with Revenue Compliance leadership, revenue compliance analysts, Revenue Cycle, Clinical Documentation Improvement (CDI) programs and others to support compliance program initiatives focusing on Medicare Conditions of Participation, billing regulations, and coding guidelines. Accountable for reviewing patient medical records to proactively assess billing accuracy. Provides direct and indirect support to colleagues including coaching, training, project delegation and oversight, regular statuses, and scheduling. Monitors internal and external revenue compliance risks, and has responsibility for supporting compliance with interpretation and analysis of billing standards. Serves as a resource for the Practice and Revenue Cycle concerning policies, procedures, and applicable regulations. Works directly with Mayo Clinic leadership to enforce policy compliance while mitigating organizational risk. Drafts and updates policies and oversees implementation of procedures. Leads multi-disciplinary workgroups and projects. Assists with investigations and responds to complaints filed with regulatory agencies. Represents compliance on institutional committees and other functions and projects as assigned. Some travel may be required to other Mayo Clinic sites and/or training conferences.
This vacancy is not eligible for sponsorship/ we will not sponsor or transfer visas for this position. Also, Mayo Clinic DOES NOT participate in the F-1 STEM OPT extension program.
Qualifications
Bachelor's degree required and a minimum of 5 years' experience in healthcare, internal audit, clinical, regulatory research, compliance, Legal, and/or Revenue Cycle. Experience in healthcare company with knowledge of existing and emerging federal and state requirements relating to revenue compliance is preferred. Master's or Juris Doctor degree preferred.• Ability to maintain highest level of confidentiality
• Healthcare provider/payer experience
• Knowledge of Federal and State regulations related to Medicare, Medicaid, billing compliance
• Effective training and presentation skills
• Complex investigation and audit experience
• Proficient in Excel, Word, and PowerPoint
• Demonstrated ability to set priorities and to respond to changing demands from multiple sources
• Ability to follow-through, meet regulatory deadlines, anticipate requirements, and build relationships
• Strong analytical and problem-solving skills
• Ability to communicate effectively with diverse groups including attorneys, physicians, patients, allied
health staff, researchers, and vendors
• Ability to lead in a team environment with minimal supervision
Preferred licenses/certifications: Compliance certification (Certified in Healthcare Compliance (CHC) or similar). Registered Nurse (RN), Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Coding Specialist (CCS), Certified Risk Adjustment Coder (CRC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Documentation Improvement Practitioner (CDIP), or Certified Clinical Documentation Specialist (CCDS).
