Compliance Officer Billing and Coding

Location: Westlinks -12801 Westlinks Drive Fort Myers FL 33913

Department: Compliance

Work Type: Full Time

Shift: Shift 1/8:00:00AM to 4:30:00PM

Minimum to Midpoint Pay Rate: $50.50 - $68.19 / hour

Summary

Responsible for the execution of compliance operations for technical and professional billing and coding. The Compliance Officer is responsible for overseeing and managing the organizations coding and billing compliance programs to ensure adherence to federal, state, and local regulations. Works with clinical, administrative, and financial teams to ensure accuracy and integrity in claims submission and reimbursement processes while mitigating regulatory risks.

Serves as the primary compliance contact for the assigned support area and is integrated into the operations he/she supports to serve as a subject matter expert on compliance requirements impact on specific operations and advises operations on process design to ensure compliance with regulations. Responsible for monitoring the regulatory changes that could impact their operational scope, development of annual compliance education plans and training coordination, conducting annual compliance risk assessments, designing and monitoring compliance workplans, coordinating compliance committee meetings, providing assistance with policy and procedures reviews and development, and assisting with the development and monitoring of compliance related corrective action plans.

The Compliance Officer oversees the Corporate Compliance Audit Managers and audit teams and coordinates the reporting and action plans for the following compliance requirements with the coding and billing departments: audit findings, compliance hotline intake and action planning, leading compliance investigations and coordinating investigations with management and peer operations, at times under Attorney-Client Privilege, and review of sanction screening results and remediation with HR and the management team.

Requirements

Education: BS or BA degree from an accredited college required. Masters degree preferred.

Experience: Minimum of 5 years of healthcare compliance, healthcare operational coding and/or billing experience is required. Minimum of 2 years of coding education experience required.

Certification: CPC (Certified in Professional Coding) required. CHC (Certified in Healthcare Compliance), CHPC (Certified in Healthcare Privacy Compliance), or Certified in Healthcare Research Compliance or equivalent certification required or must be obtained within the first 6 months of employment.

License: N/A

Other: Strong communication and relationship building are required skills to be successful. This role will require Compliance Officer to attend in person meetings and actively collaborate and build strong working relationships with the areas they support.

US:FL:Fort Myers