Compliance Analyst RMG
External
Rivhs · Newport Square Professional Center - Newport News, VAPrepare for this interview
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About the role
Primary responsibility is to independently perform clinical chart reviews, risk adjustment audits, payor audits, coding analysis, charge/reimbursement analysis, medical records reviews, and educate provider personnel on coding methodologies that will result in improved accuracy by following RMG compliance standards for commercial and government payors. This position serves as subject matter expert to coordinate review and root cause analysis of coding follow-up/denial and audit work queues, coding denial volumes, and coding trends. Responsible for identifying and reporting obstacles, patterns, and variations as well as resolutions in a timely, clear and concise manner. Serves as an expert for all coding-related questions and is responsible for providing educational materials to answer questions from clinical/office managers, providers and other administrative personnel.
Requirements
- Education
- High School Diploma or GED, (Required)
- 3-4 years Commercial and Government Billing/Coding/Collections (Required)
- 1 year Medical Record Reviews (Required)
- Licenses and Certifications
- Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC) (Required) or
- Certified Outpatient Coder (COC) - American Academy of Professional Coders (AAPC) (Required) and
- Certified Professional Medical Auditor (CPMA) - American Academy of Professional Coders (AAPC) or another AAPC recognized credential, or billing within 1 Year (Required)
- To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers .
Benefits
Additional Information
Newport News, Virginia Hiring Range $57,100.00 - $78,550.00/Annual Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs. FOR APPLICATION REVIEW - PROVIDE YOUR AAPC CERTIFICATION NUMBER ON YOUR APPLICATION OR RESUME This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA.
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