Coding and Education Auditing Services Consultant – Change Healthcare – Wyoming

Coding and Education Auditing Services Consultant

Overview of Position

This position is intended to accommodate current and future client needs/requirements in expertise and resources for Compliance Services: Corporate Governance, Independent Review Organization (“IRO”); Third Party Review Organization (“TPRO”); due diligence audits; coding/billing audits; clinical trial billing compliance; behavioral and mental health services compliance; corporate compliance program development and implementation; compliance program effectiveness assessment; development of assessment tools (manual & electronic) and targeted training contents. In addition, compliance services may be needed to support other services lines such as Revenue Cycle, Reimbursement, Strategic Analytics and Valuation.

The ideal candidate will have demonstrated expertise and experience in healthcare corporate governance, compliance and ethics to provide consulting services in adherence to regulatory requirements, clinical operations improvement, audits of coding, claim submission and billing, and process improvement to optimize reimbursement. The senior consultant contributes to the firm’s success by striving to consistently exceed client expectations, developing new skill sets and knowledge base as well as identifying new opportunities for sustained strategic growth. This is a remote/telecommuter position.

What will be my duties and responsibilities in this job?

• Acts as primary contact person and communicates with designated staff at client institutes/locations once engagement is initiated
• Prepares and submits engagement budget
• Participates in marketing and business development
• Serves as designated project manager for assigned engagements
• Provides day-to-day project oversight and guidance to assigned team members
• Assists team members in project design and requirements
• Initiates and maintains project schedule and timelines
• Oversees progress of projects and provides regular status reports/issues to senior management
• Assists assigned team members to identify and locate resource materials for referencing purposes
• Compiles and reviews documentation required for audits, assessments and reviews
• Revises and finalizes reports, cover letters and related records
• When requested, prepares project-specific summaries and presentations, including recommendations for process improvement, for exit conferences with clients
• Ensure appropriate document management, retention and storage according to internal policies and HIPAA rules where HIPAA is involved
• Monitor project specific time and effort reporting by assigned team members
• When appropriate, initiates follow-up with clients after project completion for additional business
• When appropriate, prepare suggestions and recommendations for internal process improvement for future engagements.

What are the requirements needed for this position?

• 3-5+ years of experience in hospital facility billing and Pro-Fee billing. Must have experience billing for different physician specialties
• Must have coding certifications like CPC or CCSP and an RHIT certification
• 3-5+ years of experience with EMR systems such as EPIC, Allscripts, or Cerner
• Experience preparing presentations for professional meetings
• In-depth understanding of laws, rules and regulations related to:
  • Healthcare corporate governance
  • Compliance, Ethics and HIPAA
  • Healthcare provider claim preparation, submission, and billing (facility and professional fees)

• Demonstrated ability to prepare and compile policies and procedures, narrative reports, and data spreadsheets
• Demonstrated success at managing projects, timelines, and multiple priorities
• Demonstrated ability to navigate and understand medical records, claim forms and remittance advices or Explanation of Benefits

What other skills/experience would be helpful to have?

• Demonstrated ability to succeed in a matrix management environment
• Innovative problem solving skills with ability to think outside the box
• Ability to analyze and resolve problems independently as a representative of the firm
• When appropriate, research applicable laws, rules and regulations to address issues or questions raised by clients

What are the working conditions and physical requirements of this job?

General office demands

How much should I expect to travel?

Post COVID this position may travel up to 30%. Travel to client locations, with the possibility of extended stays for more than 1 week are possible. Employees in roles that require travel will need to be able to qualify for a company credit card or be able to use their own personal credit card for travel expenses and submit for reimbursement.

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Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

Equal Opportunity/Affirmative Action Statement

Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.

If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to [email protected] with “Applicant requesting reasonable accommodation” as the subject. Resumes or CVs submitted to this email box will not be accepted.

Click here https://www.dol.gov/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf to view our pay transparency nondiscrimination policy.

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Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.