Job Information
MERCY HEALTH CORPORATION Revenue Cycle Compliance Analyst in JANESVILLE, Wisconsin
JOB REQUIREMENTS: Overview Compliance Analyst, Revenue Cycle, Days, 80 hrs / 2 wks Location: MercyCare Building, Janesville, WI. Hybrid schedule avaliable. The Revenue Cycle Compliance Analyst has the primary responsibility of performing all audits and chart reviews required for inpatient, outpatient and provider coding and billing, daily retrospective chart reviews and communication to key stakeholders regarding audit findings and corrective actions, if necessary. Work closely with other key stakeholders to identify fraudulent claims, outliers, reimbursement deficiencies, inefficiencies, incorrect codes and poor documentation to improve the organization\'s adherence to compliance policies. Provide education to other professionals regarding correct documentation and detailed recommendations to improve the organizations policies and procedures. Responsibilities Responsible for inpatient and/or outpatient coding and billing investigations and inquiries, as well as answering correspondence from key stake holders regarding inpatient and/or outpatient coding and billing matters and other general Compliance reimbursement inquiries. Continuously evaluate the quality of clinical documentation and monitor the appropriateness of queries with the overall goal of improving physician documentation and achieve accurate coding. Review the electronic health record to identify potential coding and billing compliance issues. Prepare written reports of audits, including recommendations to improve compliance. Analyze and assess Mercyhealth\'s potential risks using billing and coding claims data, risk assessment data, OIG Work plan, CMS, PEPPER Reports, RAC Denials, industry experts, etc. Works in collaboration with system management (HIM, CDI, Case Management, Quality, etc.) in developing Mercyhealth\'s standardized documentation, medical necessity, coding and billing policies and guidelines in accordance with state and federal laws, regulations and policies. Maintain current credentials and knowledge of ICD-10-CM/PCS, MS-DRG, CPT and HCPCs coding classification changes, compliance issues and updates regarding changes in federal and state regulations, policies and procedures pertaining to the Compliance Program. Demonstrated knowledge of understanding of payer rules and regulations, including Medicare and Medicaid with the ability to work independently with minimal supervision and demonstrate initiative. Adheres to a personal plan of professional development and growth through professional affiliations, activities and continuing education. Education and Experience Bachelor\'s Degree required or an additional six years of experience required in lieu of education. Two years of experience in auditing, coding or related field required; preferably within a healthcare, quality management, quality assurance, business... For full info follow application link. EOE&AA/M/F/Vet/Disabled. Mercy is an equal employment opportunity employer functioning under Affirmative Action Plans. ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/6FB4D7D9255A4837