13 days old

Billing Compliance Administrator

Weill Medical College of Cornell University
New York, NY 10007
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Position Summary

Under direction, plans, manages and oversees day\-to\-day billing compliance function\. Evaluates the departments billing compliance activities to assess compliance with the Billing Compliance Professional Compliance Plan\. This role also implements strategies to ensure accurate medical record documentation and clinical and research billing compliance\.Further, this role assists in the administrative, financial, human resource and operational functions of the Compliance and Privacy Office \(CPO\) department\.

Job Responsibilities

+ Assists in the development and implementation of policy and procedures\. Maintains, and/or disseminates departmental or functional specific policies and procedures\. Also responsible for maintaining and updating departmental SOP manual\.

+ Responsible for ensuring that audits are conducted in compliance with all regulatory guidelines and payer policies\.

+ Attends workshops, seminars and/or conferences to keep abreast of standards and best practices within the field\. Disseminates information to colleagues and/or staff as appropriate\.

+ Reviews clinical trials for budgetary and research billing compliance\. Responsible for daily, weekly and monthly compliance metrics to monitor and assess compliance for all departments\.

+ Monitors coding and medical record documentation compliance with federal and state regulations\. Educates staff on compliant coding in accordance with regulatory guidelines\.

+ Maintains and conducts reviews of the provider code dictionary to ensure it is updated expeditiously\. Reviews and approves changes in billing codes for new services\.

+ Provides guidance in implementation of screen layouts, electronic templates for medical record documentation, scripting tools, coding and interfaces within systems\. Reviews templates to ensure compliance with coding/regulatory guidelines\.

+ Manages audit platform\. Oversees prospective and retrospective compliance documentation audits\. Conducts monthly reviews of QA audits to ensure accuracy and completeness\. Tracks and trends results of audits\. Prepares and presents reports on results\.

+ Responsible for the timely submission and accuracy of all BCOC materials and reports for review and approval\. Responsible for the timely submission of weekly compliance report and the accuracy and timely submission of the compliance metrics\.

+ Responsible for annual education of compliance team on code changes, including preparation of materials, implementation and monitoring\. Tracks staff training, ensuring staff is current on regulations/coding guidelines on government and all specialties\.

+ Ensures compliance specialist education program is implemented and adhered to\.

+ Responsible for the scheduling, preparation and implementation of the Leaders & Liaisons compliance program\.

+ Responsible for tracking and ensuring accuracy of education logs and provider rosters\. Ensures compliance credentials are maintained, tracked and documented for all departments\. Ensures webinar series is current, updated and implemented annually\.

+ Tracks and logs compliance trends and issues/resolutions\. Provides expertise on optimization of compliance programs and makes suggestions to improve efficiency\.

+ Responsible for regular and systematic reporting of issues, trends and bottlenecks\.

+ Manages department meeting calendar to ensure compliance with meeting frequency standard\. Manages quartely report workflow to ensure timely submission and meeting schedule/completion\.

+ Responsible for the preliminary development of department annual report presentation schedule for approval and communication to department of their reporting period, date/time/location and due dates\.

+ Manages compliance staff time off request and timekeeping, ensuring appropriate coverage\.

+ Responsible for ensuring compliance team meets institution/department requirements \(annual training, certification renewals, required monthly webinars, etc\.\)

+ Performs other duties as assigned or required\.


+ Bachelor's Degree


Master's degree is preferred\.

Approximately 3\-5 years of previous related experience\.

Knowledge, Skills and Abilities

+ Demonstrated management experience in a large academic medical center with in\-depth knowledge of compliance and/or auditing/coding\.

Licenses and Certifications

+ Certified Professional Coder Certificate \(CPC\) or Certified Coding Specialist Physician Based \(CCS\-P\)

Working Conditions/Physical Demands

Standard office work

Weill Cornell Medicine is a comprehensive academic medical center that's committed to excellence in patient care, scientific discovery, and the education of future physicians in New York City and around the world\. Our doctors and scientists\-faculty from Weill Cornell Medical College, Weill Cornell Graduate School of Medical Sciences, and the Weill Cornell Physician Organization\-are engaged in world\-class clinical care and cutting\-edge research that connect patients to the latest treatment innovations and prevention strategies\. Located in the heart of the Upper East Side's scientific corridor, Weill Cornell Medicine's powerful network of collaborators extends to its parent university Cornell University; to Qatar, where an international campus offers a U\.S\. medical degree; and to programs in Tanzania, Haiti, Brazil, Austria and Turkey\. Our medical practices serve communities throughout New York City, and our faculty provide comprehensive care at NewYork\-Presbyterian Hospital/Weill Cornell Medical Center, NewYork\-Presbyterian/Lower Manhattan Hospital, and NewYork\-Presbyterian/Queens\. At Weill Cornell Medicine, we work together to treat each individual, not just their conditions or illnesses, as we strive to deliver the finest possible care for our patients \- the center of everything we do\. Weill Cornell Medicine is an Equal Employment Opportunity Employer\. Weill Cornell Medicine provides equal employment opportunities to all qualified applicants without regard to race, sex, sexual orientation, gender identity, national origin, color, age, religion, protected veteran or disability status, or genetic information\.
Posted: 2019-09-03 Expires: 2019-10-04

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Billing Compliance Administrator

Weill Medical College of Cornell University
New York, NY 10007

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