Appalachian Regional Healthcare

  • COMPLIANCE ANALYST

    Job Locations US-KY-Hazard | US-KY-Harlan
    Posted Date 4 months ago(4/23/2018 3:24 PM)
    Requisition ID
    2018-9460
    # of Openings
    1
    Category
    Business Professional
    Community
    System- Hazard
    Position Type
    Regular Full-Time
    Department
    Corporate Compliance
    Shift
    Day Shift
  • Responsibilities

    Performs audit engagements to ARH facilities for the purpose of reviewing, assessing the billing, coding, and documentation practices and to identify areas of risk.

     

    Provides educational in-services tailored to address identified areas of risk in billing and documentation.

     

    Reviews the medical records of Medicare patients, specifically, to insure the accuracy of the physician’s assignment of principal diagnosis, complications, co-morbidity’s, and procedures (documentation) that impact hospital reimbursement.  Reviews other payer classes as required

     

    Audits the accuracy of charges.

                           

    Prepares written reports to communicate audit findings and recommendations and participates in the exit conference.

     

    Keeps abreast of any new developments and changes in  OIG,Federal and State regulations as they relate to billing, coding and compliance issues.

     

    May assist in other auditing functions and perform other related duties as assigned.

     

    Identifies and Trends non-compliance issues within the organization for improvement.

     

    Trends denials and unbilled for resolution.

    Qualifications

     

    High School Diploma or GED Equivalent

     

    Must be computer literate in Word and Excel.

     

    Past experience in dealing with public is desired.

     

    Business or Coding Education or Experience

     

     

    One year experience in an office or one year business school education desired.

     

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