Compliance Clinician Analyst
Salary undisclosed
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Job Description
Compliance Clinician Analyst
Position Highlights:
Supports the Compliance and Integrity Department with the review of risk-based, individual clinician documentation, coding, and billing. May be asked to assist with data analysis to determine high risk coding. Conducts the identified reviews and communicates the findings to the reviewed clinician. Tracks and analyzes individual clinician reviews trends. May aid in developing and delivering compliance and regulatory educational materials to individual clinicians.
All responsibilities and requirements are subject to possible modification to reasonably accommodate individuals with disabilities.
This job description in no way states or implies that these are the only responsibilities to be performed by an employee occupying this job or position. Employees must follow any other job-related instructions and perform any other job-related duties requested by their leaders.
About Us
Atrium Health Wake Forest Baptist is a pre-eminent academic health system based in Winston-Salem, North Carolina. Atrium Health Wake Forest Baptist is part of Advocate Health, which is headquartered in Charlotte, North Carolina, and is the fifth-largest nonprofit health system in the United States, created from the combination of Atrium Health and Advocate Aurora Health. Atrium Health Wake Forest Baptist’s two main components are an integrated clinical system – anchored by Atrium Health Wake Forest Baptist Medical Center, an 885-bed tertiary-care hospital in Winston-Salem – that includes Brenner Children’s Hospital, five community hospitals, more than 300 primary and specialty care locations and more than 2,700 physicians; and Wake Forest School of Medicine, the academic core of Atrium Health Enterprise and a recognized leader in experiential medical education and groundbreaking research that includes Wake Forest Innovations, a commercialization enterprise focused on advancing health care through new medical technologies and biomedical discovery.
Wake Forest Baptist Health, Wake Forest University School of Medicine and Atrium Health have joined forces in a strategic combination that will enhance care, transform medical education and create economic opportunity for countless lives in North Carolina and beyond. As a part of that combination, the two health systems will be integrating technology and platforms, including our career sites.
This means that although you are applying on the Wake Forest Baptist Health Career Site, you receive communications from the Atrium Health Recruitment Team. Please know that this is an expected process, and thanks in advance for your flexibility.
About The Team
Mission, Vision and Culture Commitments
Mission
To improve health, elevate hope and advance healing – for all.
Vision
To be the first and best choice for care.
Culture Commitments
We create a space where all Belong
We Work as One to make great things happen
We earn Trust in all we do
We Innovate to better the now and create the future
We drive for Excellence – always
Compliance Clinician Analyst
Position Highlights:
- Shift Schedule: 40 hours per week, day shift
- Department: Physician Compliance
- Location: Atrium HealthWake Forest Baptist in Winston-Salem, NC
Supports the Compliance and Integrity Department with the review of risk-based, individual clinician documentation, coding, and billing. May be asked to assist with data analysis to determine high risk coding. Conducts the identified reviews and communicates the findings to the reviewed clinician. Tracks and analyzes individual clinician reviews trends. May aid in developing and delivering compliance and regulatory educational materials to individual clinicians.
- Participates in the execution of an annual compliance work plan; with focus on individual clinician (MD, PA, NP, CNM) reviews
- Assists in the analysis of trend coding data to identify high risk clinician billing.
- Conducts individual clinician compliance reviews by comparing documentation, coding, and billing data to regulatory guidance.
- Prepares customized reports to summarize the results of the individual clinician reviews.
- Works with other teammates on the Compliance team and Revenue Cycle to deliver feedback to clinicians on review findings based on the results of the clinicians' reviews.
- Works with leaders to perform additional reviews of clinician's activities – beyond documentation and coding - to identify potential issues with clinician activity. This may include analysis of the clinician’s workload and administrative duties.
- Works with leaders to track and follow-up with individual clinicians to ensure all corrective actions are complete.
- Assist Compliance & Integrity – Reimbursement Auditing and Monitoring leaders with research related to regulatory requirements.
- Assists Compliance & Integrity – Reimbursement Auditing and Monitoring leaders with other projects as assigned.
- Bachelors Degree or equivalent knowledge in Health Care Administration, Medical Coding, Health Information Management or health related field
- CPC or CCS-P certification
- Typically requires 3+ years of experience in a health care environment with knowledge of health care regulatory requirements and medical coding and billing experience.
- 3+ years surgery coding experience preferred.
- Working knowledge of compliance related regulations such as coding, billing, documentation requirements, Local and National Coverage Determinations, National Comprehensive Coding Initiatives, Medicare/Medicaid billing regulations, HIPAA Privacy rule, etc.
- Strong computer, problem-solving and analytical skills, including ability to perform data mining to identify aberrant patterns that may be indicative of compliance issues or trends.
- Highly motivated, team oriented, professional and trustworthy, with strong skills in personal diplomacy.
- Presentation and writing skills to prepare and organize media for delivery of reports and education to physicians, leadership and teammates.
- Demonstrated ability to handle sensitive communications with leadership, physicians, management and legal counsel.
- Strong organizational and time management skills.
- Proficiency in Microsoft Office Suite software.
- Demonstrated ability to prepare spreadsheets and presentation materials
- This position may require travel, therefore, will be exposed to weather and road conditions.
- Operates all equipment necessary to perform the job.
- Exposed to a normal office environment.
All responsibilities and requirements are subject to possible modification to reasonably accommodate individuals with disabilities.
This job description in no way states or implies that these are the only responsibilities to be performed by an employee occupying this job or position. Employees must follow any other job-related instructions and perform any other job-related duties requested by their leaders.
About Us
Atrium Health Wake Forest Baptist is a pre-eminent academic health system based in Winston-Salem, North Carolina. Atrium Health Wake Forest Baptist is part of Advocate Health, which is headquartered in Charlotte, North Carolina, and is the fifth-largest nonprofit health system in the United States, created from the combination of Atrium Health and Advocate Aurora Health. Atrium Health Wake Forest Baptist’s two main components are an integrated clinical system – anchored by Atrium Health Wake Forest Baptist Medical Center, an 885-bed tertiary-care hospital in Winston-Salem – that includes Brenner Children’s Hospital, five community hospitals, more than 300 primary and specialty care locations and more than 2,700 physicians; and Wake Forest School of Medicine, the academic core of Atrium Health Enterprise and a recognized leader in experiential medical education and groundbreaking research that includes Wake Forest Innovations, a commercialization enterprise focused on advancing health care through new medical technologies and biomedical discovery.
Wake Forest Baptist Health, Wake Forest University School of Medicine and Atrium Health have joined forces in a strategic combination that will enhance care, transform medical education and create economic opportunity for countless lives in North Carolina and beyond. As a part of that combination, the two health systems will be integrating technology and platforms, including our career sites.
This means that although you are applying on the Wake Forest Baptist Health Career Site, you receive communications from the Atrium Health Recruitment Team. Please know that this is an expected process, and thanks in advance for your flexibility.
About The Team
Mission, Vision and Culture Commitments
Mission
To improve health, elevate hope and advance healing – for all.
Vision
To be the first and best choice for care.
Culture Commitments
We create a space where all Belong
We Work as One to make great things happen
We earn Trust in all we do
We Innovate to better the now and create the future
We drive for Excellence – always