Billing Compliance Analyst - Medicare/Medicaid

Under the direct supervison of the Director of PFS, this position is responsible for JMC's billing compliance program and monitoring billing compliance activities to ensure compliance with federal and state programs. Additionally, this position will perform weekly audits of the billers and collaborate with the Billing Manager to identify risks and to present findings to improve processes and assisting the billing manager with proper protocols when identifying areas of concern or upcoming CMS changes. Other responsiblities include:

• Monitor, analyze, and report the effectiveness of billing compliance
• Review all findings with the Billing Manager and coordinate training of staff on changes or compliance issues identified
• Work collaboratively with JMC Team Members to identify and recommend strategies for process improvement
• Document education provided to Team Members, and maintain records of training sessions
• Research changes in national and local coding and billing coverage decisions
• Provide feedback in a helpful manner to appropriate parties and provides guidance to improve billing procedures
• Applications utilized include Excel, Word, Star, Cerner, HPF, Experian products through Claim Source, Contract Manager, On-Target-Revenue/RAC Manager, and others as necessary.
• Performs other duties as assigned.

• Bachelor's Degree
• Certified Coder preferred
• 3-5 years' experience related to billing compliance, revenue cycle, patient financial services, health care data analyst or other relevant experience with Federal auditing regulations, billing, and coding.
• Experience in conducting hospital research with CMS and interpretation of new legislation affecting hospital billing.
• Able to abstract and communicate federal and state documentation/transmittals with PFS department and to identify key stakeholders impacted by upcoming changes to billing and reimbursement.
• Experience in auditing billing activities to ensure compliancy with State and Federal programs.
• Demonstrated experience working as part of an interdisciplinary team.
• Ability to work independently
• Ability to be flexible, prioritize, plan and collaborate changes required by State and Federal governments.
• Excellent oral, written, and interpersonal skills.