Senior Compliance Specialist (CPC Certification)

NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children's hospital, three emergency rooms and a level 1 trauma center. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute designated comprehensive cancer center, and NYU Grossman School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. At NYU Langone Health, equity, diversity, and inclusion are fundamental values. We strive to be a place where our exceptionally talented faculty, staff, and students of all identities can thrive. We embrace diversity, inclusion, and individual skills, ideas, and knowledge. For more information, go tonyulangone.org, and interact with us onLinkedIn,Glassdoor,Indeed,Facebook,Twitter,YouTubeandInstagram.

Position Summary:
We have an exciting opportunity to join our team as a Senior Compliance Specialist.

In this role, the Senior Compliance Specialist will assist the Manager of Professional Billing Compliance in conducting inpatient and outpatient coding, billing and medical record documentation reviews in accordance with Federal, state and local regulations. Responsibilities include drafting written reports on audit findings and providing in-service training to physicians and staff

Job Responsibilities:

• Responsible for conducting audits of medical records to determine whether services provided to patients are appropriately documented and billed in accordance with Medicare, Medicaid and third party billing regulations and/or standards
• Drafts written reports that summarize medical record review findings for Manager review
• Performs assessments of new physicians to NYU Langone and provides education based on the results of the assessment. Follow-up provided as appropriate.
• Assists Manager in investigating inquires which may relate to erroneous billing and coding of services
• Performs reviews of Medicare Pre Probe audits and provides recommendations regarding the results to FGP management
• Develops relationships with FGP Practice Managers, FGP departmental administrators, operations managers, etc. to ensure open communication between the Compliance department and the physician practices
• Works closely with the physicians and FGP practices in order to educate them as to improvements in billing and documentation practices
• Provides in-services/presentations to physicians and staff post audit, to various practices per request, and as needed
• Performs billing and/or coding research for inquiries utilizing various sources such as the Internet, Federal Register, Medicare Carriers Manual, CPT-4 and ICD-10 references, CPT Assistance, and other industry appropriate resources
• Keeps abreast of ICD-10, CPT-4, HCPCS, and CDT coding changes, compliance issues and regulations and provides communication and updates regarding changes in regulations, policies or procedures pertaining to the Compliance Program
• Assists Manager with compliance training initiatives including coordinating training classes, writing and editing compliance manuals, developing PowerPoint presentations, etc.
• Performs and participates in other related duties as required

Minimum Qualifications:
To qualify you must have a Bachelors degree in Finance, Healthcare administration or related field.
Minimum of 4 years of professional coding and billing experience.
Certification in clinical coding is required.
Strong problem solving and analytical skills.
Excellent verbal and written communication skills.
Proficiency in Microsoft office.
Must be able to communicate with physicians, senior administrators and office staff.
Epic systems and/or EHR experience.

Preferred Qualifications:
Master's Degree
MDAudit Enterprise experience
Certification in dental coding

Qualified candidates must be able to effectively communicate with all levels of the organization.

NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.

NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.
If you wish to view NYU Langone Health's EEO policies, please click here. Please click here to view the Federal "EEO is the law" poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information.

NYU Langone Health provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $81,325.15 - $135,541.73 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

To view the Pay Transparency Notice, please click here