Compliance Clinician Analyst

February 13

🌲 North Carolina – Remote

Although this job is listed in North Carolina, this company may be open to hiring remote in other states.

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

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Atrium Health Wake Forest Baptist

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Atrium Health Wake Forest Baptist is a comprehensive healthcare system that includes a school of medicine, multiple hospitals, and specialized centers such as the Brenner Children's Hospital and the Comprehensive Cancer Center. The network serves the community with a wide range of medical services, including primary care, urgent care, telehealth, and specialty services in neurology, orthopedics, pediatrics, and more. Atrium Health Wake Forest Baptist is committed to healthcare equity, diversity, and supporting the communities it serves. It offers virtual care, medical records access through MyAtriumHealth, and a variety of community programs and resources.

Preventive Care • Specialized Care • Children's Hospital • Comprehensive Cancer Center • Digestive Health Center

10,000+ employees

⚕️ Healthcare Insurance

📋 Description

• Supports the Compliance and Integrity Department with the review of risk-based, individual clinician documentation, coding, and billing. • May be asked to assist with data analysis to determine high risk coding. • Conducts the identified reviews and communicates the findings to the reviewed clinician. • Tracks and analyzes individual clinician reviews trends. • May aid in developing and delivering compliance and regulatory educational materials to individual clinicians. • Participates in the execution of an annual compliance work plan; with focus on individual clinician (MD, PA, NP, CNM) reviews. • Assists in the analysis of trend coding data to identify high risk clinician billing. • Conducts individual clinician compliance reviews by comparing documentation, coding, and billing data to regulatory guidance. • Prepares customized reports to summarize the results of the individual clinician reviews. • Works with other teammates on the Compliance team and Revenue Cycle to deliver feedback to clinicians on review findings based on the results of the clinicians' reviews. • Works with leaders to perform additional reviews of clinician's activities – beyond documentation and coding - to identify potential issues with clinician activity. • Works with leaders to track and follow-up with individual clinicians to ensure all corrective actions are complete. • Assist Compliance & Integrity – Reimbursement Auditing and Monitoring leaders with research related to regulatory requirements. • Assists Compliance & Integrity – Reimbursement Auditing and Monitoring leaders with other projects as assigned.

🎯 Requirements

• Bachelors Degree or equivalent knowledge in Health Care Administration, Medical Coding, Health Information Management or health related field • CPC or CCS-P certification • Typically requires 3+ years of experience in a health care environment with knowledge of health care regulatory requirements and medical coding and billing experience. • 3+ years surgery coding experience preferred.