Compliance Analyst

Job not on LinkedIn

🕒 July 1

🐊 Florida, Idaho, +9 more states – Remote

🐊 Florida – Remote 🥔 Idaho – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote 🌲 North Carolina – Remote 🌪️ Oklahoma – Remote 🎸 Mississippi – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote ⚔️ Virginia – Remote

💵 $57.1k - $78.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

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Riverside Health

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1915

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Riverside Health is a comprehensive health care provider offering a wide range of medical services, including primary care, urgent care, specialty care, and emergency care. The organization is dedicated to enhancing the health and well-being of the communities it serves through compassionate care, innovative treatment options, and a commitment to excellence. Riverside Health provides access to specialized services such as mental health care, women's health, orthopedic services, cancer care, and more. This organization also focuses on education and support for various life stages, and offers resources like clinical trials and wellness education through blogs and podcasts. They maintain a strong community presence with outreach programs and partnerships intended to improve health. Riverside Health also offers digital access to health records through MyChart, ensuring patients can manage their health information conveniently. Their mission is to care for others with the same dedication they would show to their loved ones, focusing on patient-centered care and community impact.

📋 Description

• Independently conducts Medical Record audits following official coding guidelines • Analyzes provider coding and documentation to evaluate risks relating to future payor recovery audits • Uses expertise and discretion to apply necessary corrections to ensure compliance with payor rules and regulations • Demonstrates expertise and ensures that all Third Party Payor reviews are completed timely • Researches payor rules for support and guidance • Reports and tracks necessary corrections to ensure compliance with payor rules and regulations • Analyzes coding related to ensuring work queues are worked timely and accurately • Makes recommendations to Manager and practices/departments to resolve the denied claims

🎯 Requirements

• High School Diploma or GED (Required) • 3-4 years Commercial and Government Billing/Coding/Collections (Required) • 1 year Medical Record Reviews (Required) • Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC) (Required) • Certified Outpatient Coder (COC) - American Academy of Professional Coders (AAPC) (Required) • Certified Professional Medical Auditor (CPMA) - American Academy of Professional Coders (AAPC) or another AAPC recognized credential, or billing within 1 Year (Required)

🏖️ Benefits

• Health insurance • Flexible working hours • Professional development opportunities