Job Description
Compliance Manager Title: Compliance Manager
Location: Midtown
Org Unit: Code Compliance
Work Days:
Weekly Hours: 35.00
Exemption Status: Exempt
Salary Range: $104,900.00 - $118,200.00
*As required under NYC Human Rights Law Int 1208-2018 - Salary range for this role when Hired for NYC Offices
Position Summary Oversees physician billing activity for the Central Business Office (CBO) coding compliance, including analysis of Office of Compliance reviews and corrective action plans. Administration of coding best practices for charge entry and coding denial prevention. Subject matter expert (SME) in all coding related matters across the CBO.
Job Responsibilities - Monitors coding and medical record documentation compliance with federal and state regulations. Educates clinical staff and providers on compliant coding for maximum revenue.
- Designs audit tools and methodology for conducting audits. Conducts prospective and retrospective compliance documentation audits. Maintains integrity of electronic and hard copy files and databases.
- Monitors implementation of corrective action plans.
- Analyzes billing processes to identify potential billing risks and/or revenue opportunities.
- 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.
- Identifies trends in revenue cycle activities, including payments, denials, billing, coding and/or documentation errors. Recommends actions plans to address deficiencies. Monitors implementation of corrective action plans.
- Tracks and trends results of audits. Prepares and presents reports on results.
- Support provided to Population Health Team managing value-based programs identifying patient care opportunities.
Education - Bachelor's Degree in related field or commensurate experience.
Experience Approximately 10 years of experience in medical coding. Approximately 5 years of experience in physician billing.
Knowledge, Skills and Abilities - Demonstrated knowledge of professional billing, reimbursement, and payer coding policy.
- Demonstrated proficiency with MS Office Suite and database applications.
- Advanced level of communication and interpersonal skills.
- Strong written, verbal, and presentation skills to a wide range of audiences.
- Ability to meet deadlines and work in high volume work environment.
Licenses and Certifications - Certified Professional Coder Certificate (CPC) or Certified Coding Specialist-Physician Based (CCS-P) required.
- Certified Professional Medical Auditor (CPMA), Certified Health Compliance (CHC) preferred.
Working Conditions/Physical Demands Standard office work
Weill Cornell Medicine is a comprehensive academic medical center that is committed to excellence in patient care, scientific discovery, and the education of future physicians and scientists 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, NewYork-Presbyterian Hospital/Brooklyn Methodist Hospital, NewYork-Presbyterian Hospital/Westchester Behavioral Health Center, 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 protected status, including race, sex, sexual orientation, gender identity, national origin, color, age, religion, protected veteran or disability status, or genetic information.
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About Weill Cornell Medicine
Weill Cornell Medicine is a global healthcare leader known for the world-class patient care, cutting-edge research and top-ranked education. Every day, the employees of Weill Cornell Medicine improve lives across the city and around the globe. They help patients stay well, and our benefits and programs aim to help our employees and their families stay well by supporting their physical, financial, and professional health.
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