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Compliance & Coding Asst Dir

Corporate Compliance 
Full Time - 40 Hours
[[schedule]] 
Day Shift 
Mon-Fri, 8a-5p


Rated as one of the Top 25 Best Hospitals to Work for in the U.S., the heart of LMC is our 557-bed modern state-of-the-art facility. Winning the prestigious, "Summit Award" from Press Ganey for outstanding patient satisfaction, "Consumer Choice Award" from the National Research Corporation, all contributing to our reputation for giving our patients the highest quality care.  Lexington Medical Center was voted one of South Carolina’s “Best Places to Work” for 2019!

We are located in heart of the Midlands, right outside of Columbia, SC, and one of the most successful integrated healthcare systems in the Southeast. As the third largest employer in the Midlands, we invite you to be a part of our ongoing success and join our LMC Family.

Job Summary

**This is not a remote position **

 

This position is responsible for assisting with the day-to-day operations of the Coding and CDI departments and the Compliance auditing functions for the Lexington Medical Center Compliance department. Manages day-to-day coding compliance operational processes for auditing and monitoring and is the subject matter expert on auditing and coding software used within the departments.

 

Minimum Qualifications

Minimum Education: Bachelor's Degree from an Accredited University in Business, Healthcare Administration, or Related Field.
Minimum Years of Experience: 5 Years of Experience as a Manager that Encompasses Overall Compliance Functions (Including Healthcare Auditing, HIPAA Privacy, Coding, Revenue Cycle, Legal, and Regulatory Compliance)
Substitutable Education & Experience (Optional): None.
Required Certifications/Licensure: Coding certificate (CPC or CCS-P), Certified Professional Medical Auditor certification (CPMA), CCS (Claims Coding Specialist) or CHC (Certified in Healthcare Compliance).
Required Training: None.

Essential Functions

  • Stays current with changing regulations, policies, procedures and standards impacting professional compliance as well as coding guidelines.
  • The position assists with system-level project planning, problem resolution, personnel management and performance improvement and reports to the Director of Compliance, Coding, and CDI.
  • The individual effectively identifies and analyzes areas of weakness; research causes and formulates recommendations that enhance operations and compliance.
  • Responsible for staff quality audits and monitoring staff work for consistency and accuracy.
  • Assists with provider coding compliance audits, written reports, coding functions and other focused audits as assigned.
  • Assists with special projects and investigations as directed.
  • Analyzes audit findings and reports/tracks results for Board reporting.
  • Researches all relevant materials including but not limited to regulations, policies, procedures, and other standards such as CPT coding guidelines and CMS policies.
  • Documents audit work, findings and reporting of charge corrections to Revenue Integrity in accordance with department policy.Assists the Compliance and Coding Director with questions, gathers data, integrates and interprets data with the intent to report information and provide an analysis and recommendation of findings.
  • Familiarizes self with area of  audit under review.
  • Researches and gathers all relevant materials including but not limited to regulations, policies, and procedures, coding guidelines, and CMS rules and regulations.
  • Documents findings in accordance with department standards, communicates findings as directed by management and provides an analysis of findings with recommendations.
  • Performs special projects, audits, and investigations as requested by management as needed or assigned.
  • Performs special projects, coding and compliance audits based on identified risk areas or targeted audits (e.g., OIG work plan, RAC reviews, research billing, and physician compensation).
  • Assists, creates and delivers presentation material.
  • Complies and maintains information related to professional compliance audits across the health care system.
  • Responsible for staff quality audits, performance, productivity, and providing feedback to staff  via reports and staff education.
  • Provides courtesy and friendly service.

Duties & Responsibilities

  • Develops productive working relationships with all levels of management, staff and providers.
  • Provides one-on-one and/or group meetings with auditing staff and providers regarding coding/compliance education.
  • Assists with the development and delivery of appropriate coding and compliance training and education to coding and compliance staff and providers across Lexington Medical Center.
  • Responds to inquiries on how best to code, document and bill for services provided.
  • Maintains current knowledge of CPT and ICD coding guidelines as well as CMS policy and regulations.
  • Must maintain current knowledge of governmental policies such as local and national coverage decisions along with CMS rules and regulations impacting  compliance.
  • Reads trade journals articles related to coding and compliance and shares knowledge with peers and customers.
  • Requires strong leadership, investigative, and auditing skills.
  • Advanced and demonstrated ability to research regulations, coding queries and understands professional and facility billing and reimbursement methodologies.
  • Must be familiar with reference sources and have the ability to navigate and link various sources of regulations and standards.
  • Advanced knowledge of the audit and monitoring program for facility and professional coding requirements.
  • Must be able to understand, demonstrate, and teach compliance, billing and coding compliance to others.
  • Requires excellent verbal and written communication skills.
  • Must be able to educate physicians, mid-level providers, support staff and administration on medical record documentation requirements as set forth by the Federal Documentation Guidelines as well as other compliance education areas and audit findings.
  • Ability to assist in developing audit work plans based on data analysis of potential risk areas.
  • Works independently on "ad-hoc" and routine assignments.
  • Manages time effectively and regularly meets expected deadlines.
  • Ability to work well with others and conduct work in respectful manner.
  • Follows normal business protocol.
  • Demonstrates a positive attitude and positive communication.
  • Maintains appropriate professional conduct, appearance and language.
  • Performs all other duties as assigned.

We are committed to offering quality, cost-effective benefits choices for our employees and their families:

  • Day ONE medical, dental and life insurance benefits 
  • Health care and dependent care flexible spending accounts (FSAs)
  • Employees are eligible for enrollment into the 403(b) match plan day one.  LHI matches dollar for dollar up to 6%.
  • Employer paid life insurance – equal to 1x salary
  • Employee may elect supplemental life insurance with low cost premiums up to 3x salary 
  • Adoption assistance
  • LHI provides its full-time employees employer paid short-term disability and long-term disability coverage after 90 days of eligible employment
  • Tuition reimbursement
  • Student loan forgiveness

Equal Opportunity Employer
It is the policy of LMC to provide equal opportunity of employment for all individuals, and to remain compliant with applicable state and federal laws and regulations. LMC strives to provide a discrimination-free environment, and to recruit, select, on-board, and employ all employees without regard to race, color, religion, sex, age, disability, national origin, veteran status, or pregnancy, childbirth, or related medical conditions, including but not limited to, lactation. LMC endeavors to upgrade and promote employees from within the hospital where possible and consistent with the employee’s desires and abilities and the hospital’s needs.
 


Nearest Major Market: Columbia
Nearest Secondary Market: South Carolina