Compliance Analyst

This is a fully remote position, open to applicants in Florida, +10 more states.

📋 Description

• Conducts Medical Record audits independently in accordance with established coding guidelines.

• Evaluates provider coding and documentation to assess risks related to potential payor recovery audits.

• Utilizes expertise and judgment to implement necessary corrections to maintain compliance with payor regulations.

• Ensures that all Third Party Payor reviews are completed promptly, demonstrating proficiency in the field.

• Investigates payor rules for support and guidance in coding practices.

• Monitors and reports necessary corrections to guarantee compliance with payor regulations.

• Analyzes coding to ensure that work queues are addressed accurately and in a timely manner.

• Provides recommendations to the Manager and various departments to resolve denied claims.

⛳️ Requirements

• High School Diploma or GED (Required)

• 3-4 years of experience in Commercial and Government Billing/Coding/Collections (Required)

• Minimum of 1 year of experience in Medical Record Reviews (Required)

• Certified Professional Coder (CPC) credential from the American Academy of Professional Coders (AAPC) (Required)

• Certified Outpatient Coder (COC) credential from the American Academy of Professional Coders (AAPC) (Required)

• Certified Professional Medical Auditor (CPMA) from the American Academy of Professional Coders (AAPC) or another AAPC recognized credential, or billing experience within the last year (Required)

🏝️ Benefits

• Health insurance

• Flexible working hours

• Professional development opportunities