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Check with seller Director Billing Compliance - Healthcare - REMOTE Des Moines

Published date: April 3, 2022
  • Location: Des Moines, Iowa, United States

Strivant Health partners with physician practices to improve revenue cycle operations by optimizing people, processes and technology. We provide best in class Medical Billing, Collections, Call Center, Credentialing and Analytics that are all designed to focus on maximizing our provider clients’ revenue. This allows our client providers to stay focused on the practice of medicine, rather than the business of medicine. We have worked with over 4,000 providers representing 25 different specialties and over 30 technology platforms in our 20+ years of business.

LOCATION: This position is 100% remote working from your home office.

Hours: Monday - Friday, standard business hours

Status: Full-Time, Exempt

Benefits: Benefits eligible. We offer BCBS plans for health, dental and Vision through EyeMed. We also have company sponsored life Insurance, plus voluntary STD, LTD, critical illness, ID theft, travel insurance, 401(k) and much more. Benefits start the first of the month following your hire date.

Director Billing Compliance - Healthcare - REMOTE

The Director of Billing Compliance directs a broad and comprehensive program that manages billing compliance auditing and monitoring, due diligence billing compliance reviews, billing compliance education and corrective action coordination, and external payor program and program integrity audits. The Director of Billing Compliance ensures Strivant Health, and its clients are in compliance with all applicable billing compliance laws, rules and regulations, policies, and procedures.. The Director of Billing Compliance contributes to the success of Strivant Health's mission and values by minimizing its billing compliance risks and vulnerability to violations of complex state and federal billing laws and regulations.

Promotes a culture of compliance and ethics, to ensure quality of services delivered and reduces risk of government audits, fines, penalties, and sanctions.

Maintains appropriate liaison with state and federal law enforcement and regulatory agencies and professional compliance associations to assure awareness and early detection and prevention of potential risks and vulnerabilities

Designs and implements programs, policies, and practices to ensure that organization complies with state and federal billing and coding laws and regulations.

Acts as a consultant, investigator, educator, coordinator, and liaison across departments

Interacts with executives, management, and client physicians to provide compliance and risk management leadership and oversight.

Leads or participates in implementation of regulatory requirements through projects and assignments.

Evaluates and identifies risks and supports corrective action plans across service lines

Executes vision and strategic priorities. Links day-to-day compliance activities to strategic objectives/priorities.

Researches, analyzes, and documents company positions on complex legal issues to support billing compliance requirements
Reviews and analyze deliverables and data reports to ensure timeliness of submission and identify trends in performance and improvement opportunities
Performs audits and monitors risk assessments and documentation activities to ensure compliance
Identifies, investigates, and resolves compliance issues and develop corrective action plans to mitigate future risks
Serves as the “go to” person for all compliance activities including training and awareness programs for internal teams
Designs, implements and improves regulatory documentation and processes to address compliance issues and concerns related to all federal and state regulatory requirements, contract requirements and company standards
Organizes and undertakes reimbursement, coding, and procedural audits and clearly summarize findings and recommendations
Works in concert with corporate Officers to define and coordinate compliance strategies and action plans
Monitors billing practices and serves as point person for external billing audit activity for program integrity.

Bachelor’s degree in health care administration, compliance or related field. Master's degree preferred.

Certified in Healthcare Compliance (CHC) or comparable coding certification such as RHIA, RHIT, CCS, CCS-P, or CPC with equivalent compliance work experience.

At least 5 years’ experience in hospital and/or professional medical practice group billing, revenue cycle, HIM, or coding

At least 3 years direct experience in healthcare billing compliance handling risk assessments, auditing and reporting processes, action plans, and billing compliance training, required.

Advanced understanding of CMS Coding Compliance Guidelines, and AMA

Understanding of government payers and other commercial/managed care carrier rules and processes in a professional billing environment, inlcuidng prior experience with Medicare and Medicaid billing compliance.

Previous experience in reading and interpreting governmental statutes and regulations.

Prior experience serving as the expert in healthcare billiing compliance to Executive leadership within an organization
Demonstrated proficiency with managing client communications and meeting/exceeding SLAs

Proven working knowledge of billing compliance laws and regulations, incluing but not limited to OIG, HIPPA, and fraud, waste and abuse laws.

Strong analytical, communication and presentation skills with the ability to work independently.

Proven project management skills with a proven ability to manage multiple projects, with varying scopes and duration, involving multiple constituents while effectively meeting deadlines required.

We are looking forward to reviewing your resume!

No agencies, please!

Search tags: Patient Access, Patient Financial Rep, Revenue Cycle, RCM, Accounts Receivables Rep, Patient Account Rep, Patient Service Rep, Account Rep, Medical Coding, Medical Credentialing, Medical Referrals, Medical Billing, Payment Posting, Cash Applications

Job Type: Full-time


Job Type: Full-time

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