MUSCP - Compliance Manager

Job Description Summary

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Job Description

40% Auditing

• Complete monthly audits following all MUSCP Compliance procedures and report findings to individual audited the Physician Liaison Department Administrator Chairman or other leaders as directed on a monthly basis.
• Perform risk-based audits as needed to ensure compliance based on OIG Work Plan issues New Providers Level III Providers Annual Audit Plan or other criteria established by the CCPO Senior Manager Executive Compliance Committee or other party as applicable.
• Assist the Senior Manager and Corporate Data Manager in the developing the methodology for audits and reports to present findings in a clear concise manner. Responsible for follow up audits to validate resolution of documentation issues and completion of corrective action plans.
• Research Coding and other regulatory issues for clinicians and care team members. Respond to concerns and allegations and work with CCPO or Sr. Manager to develop corrective action plans and follow up appropriate to the issues identified.

40% Education

• Assist in the development and deployment of educational/training materials and campaigns; communicates proactively extensively throughout the system to provide education on compliance matters including but not limited to coding guidelines billing documentation and reimbursement Teaching Physician Regulations and scope of practice.
• Responsible for entering all education sessions into designated system per departmental instructions.
• Responsible for onboarding all new billing providers through one-on-one education within 30 days of start date.

20% Other Job Duties

• Collaborate with Regulatory Manager to prepare assigned area summary for Annual Compliance Report.
• Attend all Departmental Compliance meetings department division clinic or faculty meetings as requested.
• Works closely with clinicians and EMR technical staff in providing assistance and recommendations of EHR templates and other standardized documentation formats.
• Participate in monthly MUSC Physician Compliance Proficiency training as directed by the Senior Managers.
• Participate as requested of the MUSC Physician Compliance Innovation Campaign idea as directed by the Senior Managers.
• Responsible for monitoring and maintaining active and deferred charges within the work queue per departmental instructions.
• Assist Senior Managers & Regulatory Manager in the review of departmental processes policies and procedures to ensure material is up to date and promotes greater efficiency.
• Assist Sr. Compliance Managers and CCPO on special projects and other duties assigned.

Additional Job Description

Required Minimum Qualifications and Education:

• Bachelors and 3 years experience or associate degree with 5 years experience required. Internal candidates may be considered without a degree based on coding certification and relevant experience.
• Experience educating physicians in group or individual training sessions.
• Demonstrates solid technical knowledge understanding of business concepts regulatory rules and auditing procedures.
• Experience researching coding questions and providing documentation to support coding decisions.
• Extensive knowledge of ICD10 CPT HCPCS coding and Medical Terminology.
• Excellent communication and interpersonal skills.
• Must maintain credentials through education and stay current on regulatory trends and changes in the law.
• Knowledge of Microsoft Office Applications including Word Excel and PowerPoint.
• Experience with and aptitude for using medical billing software.

Required Licensure Certifications Registrations: CPC CCS-P RHIA RHIT or other medical coding certification preferred. Candidates without a current coding certification are required to obtain one within 18 months of hire.

If you like working with energetic enthusiastic individuals you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race color religion or belief age sex national origin gender identity sexual orientation disability protected veteran status family or parental status or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications merit and business need.

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Manager