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Compliance Reimbursement Consultant
Advocate Aurora HealthCompliance Consultant handling compliance and reimbursement matters for Advocate Health's Medical Group. Involves research, reporting, and collaboration across departments.
About the role
Key responsibilities & impact- Assist with hotline triage and response for Medical Group/Clinic compliance questions and concerns
- Navigation/connection to other support departments and collaboration within compliance team, as needed
- Assist with risk assessment process and remediation for Medical Group risks
- Assist with physician compensation analysis, as assigned
- Research of regulatory topics related to physician/professional services, reimbursement, and program requirements
- Prepare and present compliance reviews, regulatory, and educational information to audiences across the organization
- Assist with monthly review of regulatory updates at federal and state levels
- Prepare reports of reviews and investigations and delivers the results to Operational Leaders
- Completes special compliance related projects as needed
Requirements
What you’ll need- Bachelors Degree or equivalent knowledge in Health Care Administration, Medical Coding, Health Information Management or health related field
- Typically requires 5 + years of experience in a health care environment with knowledge of health care regulatory requirements and medical coding and billing experience
- Strong computer, problem-solving and analytical skills, including ability to perform data mining to identify aberrant patterns that may be indicative of compliance issues or trends
- Working knowledge of compliance related regulations such as coding, billing, documentation requirements, Local and National Coverage Determinations, National Comprehensive Coding Initiatives, Medicare/Medicaid billing regulations, HIPAA Privacy rule, etc.
- CCS, CCS-P CPC, CHC or CRCR certification required.
Benefits
Comp & perks- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical codingbillingdata miningrisk assessmentregulatory compliancecompliance reviewsreport preparationanalytical skillsproblem-solving
Soft Skills
communicationcollaborationpresentation skills
Certifications
CCSCCS-PCPCCHCCRCR