Compliance Manager

Job not on LinkedIn

🔥 1 minute ago

🏄 California – Remote

🏄 California – Remote

💵 $110k - $125k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

👻 Ghost score 0%

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Brault

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1990

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance • Data Analytics

Brault is a company specializing in End-to-End Revenue Cycle Management (RCM) and practice management services tailored for healthcare providers, particularly in acute care settings. With over 25 years of experience, Brault offers customized solutions in areas such as coding and billing, provider education, practice analytics, and operational support to help physician groups and hospitals navigate the complexities of healthcare management. Led by Dr. Andrea Brault and a team of experts, the company is dedicated to enhancing the efficiency and effectiveness of healthcare practices nationwide.

📋 Description

• Assure that the Company, its officers and management, employees, business associates, and clients adhere to applicable government law, regulations, policies, and procedures • Oversee adherence to the Company’s compliance program using OIG Compliance Program Guidance as a guide • Assist the General Counsel in implementing a compliance committee and lead and conduct meetings • Establish methods to improve efficiency and service quality and reduce vulnerability to fraud, abuse, waste, and other risks • Investigate, review, and respond to compliance issues, concerns, and complaints • Review governmental health plan publications and circulate or arrange training about relevant changes • Periodically revise the compliance program based on changes in company needs, laws, and payer policies • Review employee certifications and ensure standards of conduct are received, read, and understood • Develop, coordinate, and participate in compliance education and training programs • Coordinate personnel and provider checks against the Cumulative Sanction Report • Assist operations managers with internal compliance reviews and monitor departmental activities • Design and coordinate internal investigations and corrective actions • Develop policies encouraging reporting of suspected fraud and improprieties without retaliation • Process Medicare pre- and post-payment audits • Process patient complaints and disputes involving possible compliance or provider service problems • Research and develop answers to difficult coding or billing situations • Establish and perform internal reimbursement-coding audits • Report internal audit findings to Leadership bi-monthly • Track error rates and ensure improvement or outline further steps • Provide pertinent new and deleted CPT code lists for client fee schedule updates • Assist business associates and internal personnel with coding troubleshooting • Communicate with payers regarding prepayment review resolution • Review accounts and coordinate personnel needed to resolve prepayment reviews • Provide quarterly compliance training • Assist with training and troubleshooting for payment deficiencies

🎯 Requirements

• Excellent organizational skills • Excellent written and oral communication skills • Excellent analytical skills • Undergraduate degree in related field preferred • Compliance certification preferred • 5+ years of healthcare compliance, revenue cycle, auditing, or regulatory experience • Experience supporting multi-state healthcare operations • 3+ years of experience within healthcare revenue cycle operations, physician practice management, healthcare consulting, or healthcare services • Experience with large physician groups, hospital systems, or RCM organizations, preferred • Extensive knowledge of ICD10-CM and CPT coding principles and guidelines • Extensive knowledge of federal regulations and policies pertaining to physician documentation, coding, and billing • 4+ years coding experience • 3+ years auditing experience • 1-2 years supervisory experience • 3+ years’ experience responding to informal and government complaints • Ability to exercise judgment and propose courses of action where precedent may not exist • Experience in medical billing and compliance in healthcare preferred • Role operates in a professional office environment • Ability to use standard office equipment such as laptop computers, copiers and line/cell phones • Ability to occasionally lift or move up to 20 pounds