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Documentation/Coding Compliance Manager

Columbia, Maryland
Job Type
1 Aug 2022
  • Job Summary
    • Manages MedStars internal documentation and coding review program including developing and implementing audit procedures and schedules, managing vendors, managing audit data, outcomes and follow-up activities, and performing documentation and coding risk assessments. Tracks external audits including audit data, outcomes, auditor communication, practice communication and audit follow-up. Manages and conducts new employee compliance orientation and provider on-boarding as relates to compliance issues.
  • Minimum Qualifications
    • Education/Training
      • Bachelors degree, preferably in health care related field, e.g., health information management.
    • Experience
      • 3 years experience in performing professional services documentation and coding audits and training; strong knowledge of documentation and coding laws, regulations and rules; working knowledge of related healthcare fraud and abuse laws and regulations, and general compliance laws and regulations.
    • License/Certification/Registration
      • CPC (Certified Professional Coder) or equivalent certification required, other compliance credentials including Certified Internal Auditor, Certified Fraud Examiner, Certified in Healthcare Compliance are preferred.
    • Knowledge, Skills & Abilities
      • Strong writing proficiency and oral communication skills, and record of effective working relationships with other health professionals are essential. Strong analytical, organizational, project design and management, and report writing skills; working knowledge of various computer software application, including Microsoft Office applications (at least Word, Excel and Power Point), working knowledge of current coding software.
  • Primary Duties and Responsibilities
    • Assists Director and appropriate practice associates to highlight provider performance issues that lead to documentation and coding concerns, and ensure that practices have a process to address chronic poor performers.
    • Assists in the development and implementation of documentation and coding audit and training procedures and schedules, including training goals, protocols and process for audits/reviews, audit scoring methodology, and any related work flow processes.
    • Assists in the development and implementation of monitoring activities necessary to ensure ongoing compliance with appropriate recordkeeping.
    • Conducts new employee orientation as relates to compliance matters.
    • Conducts provider on-boarding as relates to appropriate recordkeeping, including education, auditing and other monitoring activities.
    • Contributes to OCBI reporting initiatives, including the Audit and Compliance Committee reports and OCBI dashboard reporting.
    • Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations.
    • Educates providers, through direct interaction and print communications, to promote their understanding of recordkeeping and coding deficiencies, and ways to improve performance.
    • Engages directly with providers during the training, auditing and monitoring processes to ensure their understanding of the process, timeline, and outcomes management activity.
    • Ensures that all MedStar Health providers understand MedStars documentation and coding review program goals and procedures, through education, auditing, and re-training as needed.
    • Ensures that MedStar Health providers meet all regulations governing recordkeeping, through education, auditing, and re-training as needed.
    • Manages MedStars internal documentation and coding review program including audit and training schedules, and vendor relationships.
    • Participates in multidisciplinary quality and service improvement teams as appropriate. Participates in meetings, serves on committees and represents the department and hospital/facility in community outreach efforts as appropriate.
    • Performs other duties as assigned.
    • Prepares reports and presentations as necessary to support audit, training and other assigned work.
    • Tracks external audits and assists with development of response strategy and communication.
    • Understands and tracks current federal, state and other applicable regulations that govern appropriate recordkeeping, coding and billing.
    • Verifies that coding of documentation meets all federal and state regulations and guidelines, and meets MedStar Health revenue cycle goals for appropriately capturing services and charges, through education, auditing, and re-training as needed.
About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation and research. Our 30,000 associates and 5,400 affiliated physicians work in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest visiting nurse association in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar is dedicated not only to teaching the next generation of doctors, but also to the continuing education and professional development of our whole team. MedStar Health offers diverse opportunities for career advancement and personal fulfillment.
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  • Job Reference: 673803942-2
  • Date Posted: 1 August 2022
  • Recruiter: MedStar Health
  • Location: Columbia, Maryland
  • Salary: On Application
  • Sector: Administration
  • Job Type: Permanent