Compliance Manager

Medical University of South Carolina • Charleston, SC

43d • Onsite

About The Position

Manages professional coding and billing compliance operations for assigned specialties, providers, and care team members in accordance with the MUSC Physicians Compliance Plan and contracted entities supported by MUSC Physicians Compliance. Provides education to physicians, providers, and staff, and serves as a subject matter resource to assigned departments on coding, billing, and regulatory requirements. This position is not remote; candidate must live within the Tri-County area.

Requirements

• High school diploma or equivalent required
• Minimum of 2 years of experience in billing, coding, or compliance
• Demonstrated technical proficiency with a strong understanding of business principles, regulatory requirements, and auditing processes.
• Working knowledge of ICD-10, CPT, HCPCS coding, and medical terminology required.
• Excellent written and verbal communication skills, with strong interpersonal abilities.
• Must exercise sound judgment in advancing compliance initiatives in alignment with MUSCP Compliance Department and organizational policies and procedures.
• Proficiency in Microsoft Office applications, including Word, Excel, and PowerPoint, required.

Nice To Haves

• Associate or bachelor’s degree preferred.
• Experience researching and responding to coding inquiries and/or educating professional billing providers is preferred.
• CPC, CCS-P, RHIA, RHIT or other medical coding certification preferred.

Responsibilities

• Complete assigned monthly audits in accordance with all MUSCP Compliance procedures, prioritizing audits as directed; report findings to the audited individual, Physician Liaison, Department Administrator, Chairman, and other designated leaders, while also monitoring, prioritizing, and maintaining active and deferred charges within the work queue in compliance with departmental guidelines.
• Provide comprehensive compliance support to the assigned specialty by serving as the primary compliance contact; attending meetings; delivering billing and regulatory education; researching coding and compliance issues; addressing concerns or allegations; collaborating with leadership to develop and implement corrective action plans in alignment with departmental procedures and the compliance plan; maintaining open communication with clinical, administrative, and leadership teams; monitoring regulatory and industry updates and communicating changes; and partnering with clinicians and EMR staff to support appropriate documentation standards and EHR template optimization.
• Assist with Compliance Department responsibilities as outlined in the MUSCP Compliance Plan, including but not limited to supporting departmental compliance activities, policy and procedure review, risk assessment participation, audit evaluation and process improvement, preparation of annual compliance reporting materials, and other related duties as assigned.
• Consistently demonstrate and maintain the professional competencies and soft skills required for advancement within the career ladder, including effective communication, collaboration, critical thinking, sound judgment, accountability, adaptability, and a commitment to professionalism and continuous development.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED