Senior Director of Auditing and Coding Compliance

RadNet Los Angeles • Los Angeles, CA, United States • $200k - $250k / year • 1m ago

Artificial Intelligence; Advanced Technology; The very best in patient care. With decades of expertise, we are Radiology Forward. With dynamic cross-training and advancement opportunities in a team-focused environment, the core of our success is its people with the commitment to a better healthcare experience. When you join us as a Senior Director of Auditing and Coding Compliance, you will be joining a dedicated team of professionals who deliver quality, value, and access in the 21st century and align all stakeholders - patients, providers, payors, and regulators to achieve the best clinical outcomes.

You Will:

Oversee compliance department auditing and monitoring functions
Create, integrate and implement new protocols, guidelines, policies and procedures and audit tools
Oversee and manage the Compliance Manager and auditing team
Ensure timely performance and consistency of the collection and analysis of data and documentation
Prepare documents of compliance audit findings and recommendations for Quarterly Compliance Committee meetings
Communicate findings and recommendations for corrective action to the Corporate Compliance Committee
Manage the corrective action process encourage timely follow up across departments
Support the Senior Vice President of Compliance and Regulatory Affairs (SVPCRA) with compliance matters
Maintain collaborative relationship with Revenue Cycle Operations leadership on compliance and reimbursement matters
Research and provide answers to questions asked about regulation, regulators and impacted business practices
Review and assist with drafting of policies and procedures on behalf of Compliance
Assist in the development and implementation of other components of the compliance program
Update Compliance and compliance related training and awareness-raising programs and materials
Maintain awareness of federal and state payer Integrity Program contractor activities.
Assist with responding to government investigations, probes, audits and queries in coordination with General Counsel and associated leadership

You Are:

Genuinely passionate about customer service and exercise sound judgement and an ability to remain professional in all situations
Able to demonstrate high level of attention to detail, excellent organizational skills and have the ability to multitask
Able to thrive in a fast-paced environment, have a knack for prioritizing work with a structured approach, and enjoy providing world class customer service

To Ensure Success In This Role, You Must Have:

Understanding of how external forces in the healthcare industry affect operations and revenues.
Ability to exercise a high degree of initiative, judgment, discretion and decision-making to achieve department and organizational objectives.
Ability to communicate effectively through verbal and written communication.
Ability to share information effectively and provide appropriate direction to team members.
Ability to delegate responsibility and authority to team members.
Ability to maintain proactive relationship with referring physicians.
Respond to compliance and training attestations requested by third party payors.
Knowledge of state and federal health regulations.
Knowledge of developing budgets, general computer skills, and Microsoft Office knowledge.
Demonstrates leadership skills in interactions with peers in senior management.
Maintains a “team” mentality within Compliance and Quality Assurance teams and as a member of senior management.
Must have current and maintain certification as one of the following: Radiology Certified Coder (RCC), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician (CCS-P).
Knowledge and understanding of CMS Regulatory, MAC and Medicaid/MediCal guidelines as well as knowledge of payment schemes for outpatient encounters.
Knowledge and ability to follow standard practices in coding and reimbursement with knowledge of CPT, ICD, and HCPCS codes.
A four-year degree in business administration or health care administration or six or more years of experience in the radiology service industry and management experience.