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Sr., Compliance Consultant - Revenue Cycle

Date:  Jun 18, 2022
Location: 

Dallas, TX, US

Category:  Corporate and Professional Jobs
Job Type:  Day
Requisition ID:  587081

Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become part of a diverse healthcare legacy that’s served our community for more than 125 years. Put your skills to work with us, seek opportunities to learn and join a talented team where patient care is more than a job. It’s our passion.

Primary Purpose
The Senior Revenue Cycle Compliance Consultant is responsible for performing a variety of activities in support of compliance program initiatives, with a focus on revenue cycle compliance.

 

Minimum Specifications
 

Education

  • Must have a bachelor’s degree in a clinical field, healthcare administration, business administration or related field.

 

Experience

  • Must have six (6) years of progressively responsible experience in a healthcare related administrative, financial, or compliance role with a minimum two (2) years’ experience conducting compliance-related reviews and audits involving federal healthcare programs such as Medicare and Medicaid.
  • Must possess mastery-level expertise in documentation requirements, coding and billing requirements and federal and state regulatory requirements for billing compliance.
     

Equivalent Education and/or Experience

  • May have an equivalent combination of education and experience in lieu of specific education and/or experience as stated above.

 

Certification/Registration/Licensure

  • Certification in a healthcare compliance-related specialty is required

•   Must be currently certified and in good standing with one of the following:

  • Certified in Healthcare Compliance (CHC)
  • Certified Fraud Examiner (CFE)
  • Accredited Health Care Fraud Investigator (AHFI)
  • Certified Revenue Cycle Professional (CRCP)
  • Certified Professional Coder (CPC)
  • Certified Outpatient Coder (COC)
  • Certified Compliance Specialist (CCS)

 

Required Tests for Placement
 

Skills or Special Abilities

  • Must have excellent verbal and written communication skills.
  • Must be able to communicate effectively with all levels of personnel and demonstrate tact and diplomacy skills. 
  • Must have strong organizational and planning skills. 
  • Must demonstrate a high degree of personal integrity and practice ethical standards. 
  • Must demonstrate strong leadership skills.
  • Must be proficient with Microsoft Office, electronic medical records and coding, billing and claims payment applications.


Responsibilities

  1. Conducts reviews to determine whether claims reflect the appropriate ICD-10-CM and CPT/HCPCS codes. Consults with management to report findings and provide corrective action recommendations.
  2. Conducts routine monitoring in an effort to prevent, detect and respond appropriately to revenue cycle compliance risks. Consults with management to report findings and provide corrective action recommendations.
  3. Conducts thorough research and provides prompt, courteous consultative services regarding revenue cycle compliance matters.
  4. Assists in monitoring and responding to audits and/or inquiries from government agencies and contractors.
  5. Assists with the development of new, or revisions of, existing policies and procedures, as warranted, based upon regulatory developments and compliance monitoring and auditing activities/findings.
  6. Stays abreast of the latest developments, advancements, and trends in revenue cycle compliance. Monitors changes in laws and regulations related to revenue cycle compliance and communicates changes to appropriate personnel.
  7. Collaborates with personnel across Parkland particularly in the Internal Audit, Patient Financial Services, Health Information Management, Care Management, Government Reimbursement, Regulatory and Accreditation, Clinical Research, Clinical Support Services, and Legal Department, and with representatives of UTSW. 
  8. Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.
     

Job Accountabilities

  1. Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.
  2. Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.
  3. Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding.

 

#LI-RB1

Parkland Health and Hospital System prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.


Nearest Major Market: Dallas
Nearest Secondary Market: Fort Worth

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