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Posted: 11-Jan-25
Location: Saint Louis, Missouri
Internal Number: 84285
- Remote opportunity- must reside in the Greater St. Louis Metropolitan area for occasional in person meetings.
- Previous auditing experience of evaluation and management and surgical procedures is preferred!
- Working knowledge of EXCEL and MS Publisher.
Overview
BJC Medical Group is the multi-specialty physician-led organization of BJC HealthCare and includes over 600 doctors and advanced practice providers who are affiliated with top-ranked hospitals in the Midwest region.
Since 1994, BJC Medical Group has provided access to extraordinary care in over 145 locations and over 25 specialties in the greater St. Louis, mid-Missouri and southern Illinois areas. Our providers are nationally recognized for excellent patient satisfaction, quality health care, and improving the health and well-being of the communities we serve.
The Quality and Compliance Department provides support to the strategic and operational objectives of BJC Medical Group practices is located in Town & Country, MO.
Preferred Qualifications
Role Purpose
The Compliance Coordinator conducts and coordinates reviews of BJCMG primary care providers? documentation to ensure accuracy of services billed. This position prepares reports of findings to be presented to providers. This position also provides educational opportunities for new and existing primary care providers, giving instruction on federal and state regulations, documentation guidelines, and coding training in a way that ensures compliance with governmental regulations. Additionally, the Compliance Coordinator collaborates with departments in providing appropriate education to staff as it relates to compliance and privacy of protected health information.
Responsibilities
- Conducts and coordinates routinely scheduled reviews of BJCMG primary care providers? documentation involved with professional fee billing, for accuracy of coding and physical presence; these reviews consist of ambulatory E&M services and office procedures, as well as hospital admissions, subsequent visits, hospital procedures, and all other services performed by BJCMG primary care providers; reviews medical record documentation to identify under-coded and up-coded services, prepare reports of findings, and meet with providers to provide education and training on accurate coding practices and compliance issues as a result of the review.
- Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services identified as part of the review for primary care providers.
- Interacts with primary care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation based on the review.
- Provides training, instruction, and support to primary care providers and coders, as appropriate, regarding coding compliance documentation, regulatory provisions, and third party payer requirements as a result of the review or as request by management.
- Assists team with requests from government agencies/contractors, management, employees and others, as necessary, to ensure an understanding of the organization?s compliance initiatives as requested by management related to primary care providers.
Minimum Requirements
Education
- High School Diploma or GED
Experience
- 2-5 years
Supervisor Experience
- No Experience
Licenses & Certifications
- CCS/CPC
Preferred Requirements
Education
- Associate's Degree
- Business/HC Admin/related
Licenses & Certifications
- RHIA/RHIT
Benefits and Legal Statement
BJC Total Rewards
At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.
- Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
- Disability insurance* paid for by BJC
- Pension Plan*/403(b) Plan funded by BJC
- 401(k) plan with BJC match
- Tuition Assistance available on first day
- BJC Institute for Learning and Development
- Health Care and Dependent Care Flexible Spending Accounts
- Paid Time Off benefit combines vacation, sick days, holidays and personal time
- Adoption assistance
To learn more, go to www.bjctotalrewards.com/Benefits
*Not all benefits apply to all jobs
The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer