Supports all aspects of Exeter Hospital's Integrity and Compliance Program to include: (1) researching documentation coding and billing requirements (2) conducting investigations audits and monitoring of internal processes and controls to ensure compliance with applicable statutory and regulatory requirements and organizational policies; (3) educating management clinicians and staff; and (4) providing guidance and assistance to hospital departments in operationalizing statutory and regulatory requirements.
- Bachelor's Degree or equivalent experience with clinical background and experience preferred
- 3-5 years experience in hospital inpatient and outpatient coding/auditing/compliance program implementation
- Effective oral and written communication skills
- Excellent skills in Microsoft Word and Excel
- At least one of the following: Certified Professional Coder (CPC/CPC-H), Certified Coding Specialist (CCS) or Registered Health Information Technician (RHIT)
- Conducts investigations; audits and monitoring of internal processes and controls to ensure compliance with applicable statutory and regulatory requirements. Prepares reports of investigations; audits and monitoring with clear and concise findings and recommendations.
- Researches and provides guidance concerning documentation; coding and billing requirements. Acts as a resource to physicians; non-physician providers; support staff; administrators and other personnel concerning the interpretation and implementation of Medicare; Medicaid and other third party payer documentation; coding and billing requirements.
- Creates a working relationship with clinicians; management and staff to promote the effectiveness of Exeter Hospital's Integrity and Compliance Program. Acts as a bridge between the Finance Department and clinical areas to operationalize statutory and regulatory requirements and organizational policies and coordinate the implementation of remedial measures; when necessary.
- Provides ongoing education and training to support the effectiveness of Exeter Hospital's Integrity and Compliance Program.
- Maintains tracking systems for compliance related issues and assists in preparing reports on the status of investigations; findings; and remedial measures.
- Assists Compliance Officer with other activities that support all aspects of Exeter Hospital's Integrity and Compliance Program as necessary.