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Audit and Compliance Analyst

Long Island Vision Management – Hauppauge, NY

Description:
SightMDs vision is to be the greatest eye company the world has ever seen. Our mission is to provide an unparalleled care experience for patients with 7-days-a-week access to world-class quality eye care in the convenience of their local neighborhoods, delivered by a dedicated, caring and talented healthcare team.
SightMD is looking for a career minded individual to be at the heart of that mission and assist in the daily practice audit and compliance activities. As an Audit and Compliance Analyst, you will play a vital role in supporting the adherence to SightMD s audit and compliance programs. You will act as a liaison to the billing department, clinical department, as well as SightMD s corporate compliance team. In this liaison role, you will assist by researching audit and compliance findings and working with subject matter to correct deficiencies. You will inform the respective responsible parties, monitor progress of audit findings and interact with the auditors over remediation plans. This position will also support the confidentiality of protected health information (PHI) by ensuring that PHI is safeguarded. This will be accomplished by working with the Compliance Team to close gaps where HIPAA breaches may have occured. You will provide monitoring, education and reporting to determine where exposures may exist. You will be essential in bringing closure to audit-related items and in completing strong remediation plans if errors are found. This role will be essential in maintaining communication and action between the billing department, clinical department and corporate compliance team. Prior medical compliance experience is highly preferred. You should be able to communicate professionally, be highly organized, have a strong customer service background, possess excellent computer and organizational skills, and embody a welcoming/friendly demeanor.
Your responsibilities include, but are not limited to the following:
  • Manage and perform internal and external chart review process and on-going review of coding and documentation of all clinical providers throughout our 30+ practice locations
  • Provide written feedback on chart reviews performed in a timely manner
  • Maintain excellent documentation of all reviews, methodologies employed, results, corrective actions implemented, and monitoring
  • Perform risk analysis and assist in coordinating proactive corrective measures to address any shortfalls
  • Assist in creating educational materials and subsequent effective roll-out via web conferencing and individual or classroom setting
  • Provide advisement to physicians and staff related to coding practices
  • Special projects and other duties may be assigned as needed.
Requirements:
  • Bachelor s Degree in business or healthcare management.
  • Three to five years of coding and/or auditing experience
  • Demonstrated knowledge of CPT, ICD-9/ICD-10, coding guidelines and rules.
  • Proven ability to quickly grasp changes in coding rules and apply them to physician practice standards.
  • Strong verbal and written communication skills required.
  • Stellar analytical and problem solving skills.
  • Able to manage multiple tasks with minimal supervision, have exceptional attention to detail and perform consistent work product validation/QA.
  • Self-motivated, self-directed, team oriented, highly confidential, responsible and reliable, with a positive attitude and a proactive style.
  • Ability to work constructively with a wide variety of projects and changing business priorities and timeliness.
  • Medical background or training and deep understanding of medical chart requirements, compliance, and professional medical practice needs. Ophthalmology background preferred.
  • Certification in professional coding preferred.
  • Current and ongoing working knowledge of audit and compliance programs, maintaining program integrity for health care entities.
  • Bilingual in English and Spanish or ability to speak other languages is desirable.
  • Evenings and weekends may be required based on the location/office hours.
  • SightMD provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law.

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