Corporate Compliance Program Manager and Auditor - Newark, United States - University Hospital, Newark NJ

Description

Responsibilities:

The Corporate Compliance Program Manager and Auditor serves as a resource to assist the Chief Compliance Officer with activities related to corporate compliance auditing and monitoring, periodic compliance risk assessments and compliance and operational assessments.

Assists with ongoing monitoring of key elements of the compliance programs.

Ensures that UH is in compliance with state and federal laws and regulations pertaining to Corporate Compliance and HIPAA Privacy.

Handles revenue cycle compliance, sanction screening, non?monetary compensation, external billing and coding audits, and billing compliance concerns. Supports both external and internal compliance audits. Provides advisory assistance regarding billing compliance matters. The candidate will also assist with other special projects as needed.

Qualifications:
Bachelors Degree and six (6) or more years of relevant healthcare experience in supervision preferably in coding and/or compliance. Knowledge and understanding of ICD?10?CM/PCS, CPT, HCPCS, HCC coding and of current healthcare laws and regulations. Proficiency in Microsoft Office (Word, Excel, PowerPoint, and Excel).

Must possess a proficient understanding of the Inpatient and Outpatient prospective Payment Systems (IPPS/OPPS), Medical Severity Diagnosis?Related Groups (MS?DRG), and National Correct Coding Initiative Edits (NCCI Edits).

Ability to demonstrate interpersonal and organizational skills to achieve desired goals and to interact effectively with management and non?management personnel.

COC, CPC, CPMA certification from American Academy of Professional Coders (AAPC) or CCS, CCS?P, RHIT, RHIA credential from American Health Information Management Association (AHIMA) required.

CHC certification from the Health Care Compliance Association, or willing to attain within one year of hire is required. Demonstrated knowledge of how to accomplish superior performance in a unionized environment is preferred.


Credential Required:
Bachelors Degree