Sr Billing Compliance Specialist

Children's Hospital of Philadelphia•Philadelphia, PA

46d

About The Position

Assists the Senior Director with reviewing and analyzing billing processes and conducting auditing and monitoring to ensure compliance with applicable healthcare regulations. Assist Director with ongoing projects and provides guidance to departmental staff.

Requirements

At least ten (10) years related experience - Required
High School Diploma / GED - Required
Knowledge of Microsoft Office Suite including PowerPoint, Excel and Access; internet research skills.
Excellent communication and interpersonal skills required. Must be able to communicate with physicians, senior administrators and office staff.
Excellent organizational skills.
Analytical abilities.
Excellent written and oral presentation skills.
Eagerness to learn new areas and work with little supervision.
Good judgment.
Ability to work with confidential materials and to juggle multiple tasks.

Nice To Haves

CPC (Certified Professional Coder) certification through AAPC is strongly preferred
Bachelor's Degree healthcare, business, communications, education law or related field - Preferred

Responsibilities

Assist the Director in projects and investigations
Manage departmental projects and special audits completed by the Department
Responsible for maintaining all coding guidelines; create and/or review annually
Assists with compliance auditing process, including developing audit plans, conducting audits or managing the conduct of audits, reporting results and making recommendations for improvement
Assists in the development of education & training
Monitors Federal and local statutes and regulatory changes and makes recommendations for process improvement
Researches and analyzes compliance issues utilizing various publications including extensive use of the internet, the Federal Register, the Medicare Carriers Manual, and other industry publications; makes recommendations for process improvements, and monitors corrective action plans
Provide guidance to OCP compliance staff and to billing and other staff across the institution, as directed by the Senior Director
Maintain MD Audit software; troubleshoot issues
Participates in assigned organization committees
Perform other duties or special projects to support the billing compliance program, as required