RHIA Compliance Associate, II
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Job Description
Compliance Associate II ensuring documentation supports CPT codes billed to government payors. Responsibilities include auditing, investigations, and regulatory compliance for Northwestern Medicine.
Responsibilities:
- audting/reviewing provider documentation, coding, and billing to ensure that the documentation supports the CPT codes billed to government payors.
- Results of the provider audits/reviews are shared with the provider.
- Strong coding understanding, professional coding certification is required.
- Responsible for answering inquiries related to professional documentation, coding, and billing regulatory requirements.
- Work with Senior/Manager/Director on more complex issues or investigations.
- Help manage all aspects of the Compliance Hotline and compliance issues received via e-mail and phone.
- Ensure reported issues are appropriately received, evaluated, investigated, documented, and resolved.
- Respond to queries or allegations and triage issues to appropriate departments when necessary (i.e., Human Resources Compliance).
- Assist with maintaining a log/database of all issues received by the department through the compliance hotline, e-mails, phone calls, etc.
- Document all issues received, actions taken, and resolutions.
- Maintain a current understanding of regulatory trends and changes in compliance and regulatory guidelines.
Requirements:
- Bachelor's Degree
- RHIA, CPC or similar credential
- Demonstrated ability to work with various levels within the organization regarding confidential information and maintain sensitive data.
- Strong interpersonal and communications skills required.
- Ability to work collaboratively and communicate with others in a clear, concise, and professional manner on the telephone and in person, as well as demonstrate use of good written and verbal communication skills.
- Knowledge and experience in using Word, Excel, PowerPoint, Access and similar Office programs.
- Certified Healthcare Compliance (CHC) certification preferred.
- JD, MBA or similar degree preferred.
- Healthcare compliance experience preferred.
Benefits:
- tuition reimbursement
- loan forgiveness
- 401(k) matching
- lifecycle benefits
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