Clinical Documentation & RCM Compliance Lead

Essen Healthcare; New York (NY); Hybrid; USD 80,000 - 110,000; Full time

Job summary

Essen Healthcare is looking for an Operational Compliance Lead to manage RCM compliance. This position is vital in ensuring compliance with auditing standards and requires a clinical background. Responsibilities include conducting chart reviews, delivering education to clinical staff, and managing corrective action plans.

Your expertise will impact the organization’s ability to maintain audit readiness. Candidates with a bachelor's degree in healthcare administration or related fields are encouraged to apply.

Qualifications

• Minimum 3 years of operational compliance, coding, clinical chart review, or RCM experience.
• Strong knowledge of ICD‑10‑CM, CPT, HCPCS, HCC/Risk Adjustment, Medicare/Medicaid regulations, and HIPAA.
• Experience providing provider education and compliance training.

Responsibilities

• Conduct routine and targeted clinical chart reviews and RCM audits assessing coding accuracy.
• Develop, own, and drive Corrective Action Plans (CAPs) to confirmed completion.
• Deliver targeted education to physicians, NPs, and staff on documentation best practices.

Skills

Clinical Documentation Integrity

Compliance Auditing

RCM & Revenue Integrity

Provider Education & Coaching

Project Management

Education

Bachelor's Degree in Healthcare Administration, Nursing, Health Information Management, Public Health, or related field

Active coding certification: CPC, CRC, CCS, or equivalent

Tools

eClinicalWorks (eCW) or similar EMR systems

Job description

Essen Healthcare is looking for an Operational Compliance Lead to manage RCM compliance. This position is vital in ensuring compliance with auditing standards and requires a clinical background. Responsibilities include conducting chart reviews, delivering education to clinical staff, and managing corrective action plans.

Your expertise will impact the organization’s ability to maintain audit readiness. Candidates with a bachelor's degree in healthcare administration or related fields are encouraged to apply.