Sr. Compliance Coordinator-Billing & Coding

BJC HealthCare; St. Louis (MO); Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a Senior Compliance Coordinator to ensure billing accuracy and compliance within their multi-specialty physician-led organization. This role involves analyzing provider documentation, conducting educational training on coding and compliance regulations, and collaborating with various departments to promote understanding of compliance initiatives. With a commitment to exceptional care and community well-being, this organization offers a supportive environment for professional growth and development. Join a team dedicated to improving healthcare quality and making a significant impact in the field.

Benefits

Medical, dental, and vision insurance

Disability insurance

Pension and 403(b) plans

Tuition assistance

Learning and development opportunities

Flexible Spending Accounts

Paid Time Off

Adoption assistance

Qualifications

• 5-10 years of experience in compliance and billing.
• CCS/CPC certification preferred for this role.

Responsibilities

• Research and respond to compliance inquiries and coding issues.
• Develop educational training on coding and documentation rules.
• Conduct reviews of provider documentation for billing accuracy.

Skills

Provider Data Analysis

Billing Guidelines Training

Auditing Experience

Excel

MS Publisher

Education

High School Diploma or GED

Associate's Degree in Business or Healthcare Administration

Tools

Excel

MS Publisher

Job description

Additional Information About the Role

• Remote opportunity!
• Experience with analyzing provider data and training on current billing guidelines to identify trends is a plus!
• Previous auditing experience of evaluation and management and surgical procedures is preferred!
• Working knowledge of EXCEL and MS Publisher.

Overview

BJC Medical Group is the multi-specialty physician-led organization of BJC HealthCare, comprising over 600 doctors and advanced practice providers affiliated with top-ranked hospitals in the Midwest.

Since 1994, BJC Medical Group has provided access to exceptional care across over 145 locations and more than 25 specialties in the greater St. Louis, mid-Missouri, and southern Illinois regions. Our providers are nationally recognized for excellent patient satisfaction, quality healthcare, and community well-being.

The Quality and Compliance Department supports the strategic and operational goals of BJC Medical Group practices and is located in Town & Country, MO.

Preferred Qualifications

Role Purpose

The Senior Compliance Coordinator reviews and coordinates assessments of BJCMG specialty provider documentation to ensure billing accuracy. This role involves preparing reports of findings for providers, developing educational opportunities on federal and state regulations, documentation guidelines, and coding training to ensure compliance. The Coordinator collaborates with departments to provide education on compliance and privacy of protected health information.

Responsibilities

• Researches, analyzes, and responds to inquiries regarding compliance, coding issues, denials, and billable services identified during reviews or upon management request.
• Interacts with specialty providers regarding billing and documentation policies, procedures, and regulations; clarifies conflicting or ambiguous documentation based on reviews.
• Develops and presents educational training to providers and coders based on review findings; educates on coding, documentation rules, regulations, and third-party requirements, including orientation for new employees and providers.
• Engages with government agencies, management, and staff to promote understanding of compliance initiatives.
• Conducts scheduled reviews of specialty provider documentation related to professional fee billing, including ambulatory E&M services, procedures, hospital admissions, and other services; identifies under- and over-coded services, reports findings, and educates providers on proper practices.
• Performs focused reviews based on the annual work plan or emerging trends, and develops training on compliance issues.
• Mentors fellow coordinators on audits, coding, billing, and compliance; communicates educational needs or concerns to management.
• Supports the HIPAA liaison with employee investigations as needed.

Minimum Requirements

Education

• High School Diploma or GED

Experience

• 5-10 years

Supervisor Experience

• None

Licenses & Certifications

• CCS/CPC

Preferred Requirements

Education

• Associate's Degree in Business, Healthcare Administration, or related field

Licenses & Certifications

• RHIA/RHIT

Benefits and Legal Statement

BJC Total Rewards

We are committed to providing benefits and resources to support your physical, emotional, social, and financial well-being, including:

• Medical, dental, vision, life insurance, and legal services from day one
• Disability insurance paid by BJC
• Pension and 403(b) plans with BJC contributions
• Tuition assistance from day one
• Learning and development opportunities
• Flexible Spending Accounts
• Paid Time Off
• Adoption assistance

Learn more at www.bjctotalrewards.com/Benefits. Not all benefits apply to every position.

This description provides a general overview of the role's responsibilities and requirements and is not exhaustive. BJC is an Equal Opportunity Employer.