Revenue Cycle Compliance Coordinator

This Revenue Cycle Compliance Coordinator is responsible for the design, implementation, and monitoring of the revenue cycle compliance program for the Fairview system. Focus areas include all compliance concerns related to HIMS coding, charge capture, and billing-related functions, confidentiality policies, medical record documentation practices and standards, and other compliance and regulatory concerns. This position is also responsible for compliance-related process analysis, education and training, auditing and development of action plans, and special projects.

Responsibilities

• Subject matter expert in guidelines and regulations associated with revenue cycle functions.
• Serves as liaison between corporate compliance, revenue cycle, and clinical operations.
• Develops and implements annual revenue cycle compliance plan, and ensures expectations noted in the plan are achieved.
• Educates and trains staff on compliance-related topics, and coordinates education of staff around charging, coding and billing regulatory or payor changes.
• Coordinates responses and action plans to internal and external audits, ensuring timely responses and completion of commitments as defined in action plans.
• Reviews internal and external data trends to evaluate outliers and areas of risk.
• Audits department processes to assess level of compliance.
• Coordinates the development and approval of department policies and procedures to assure compliance with regulations/rules/laws.
• Ensures timely and accurate work.
• Contributes to the process or enablement of collecting expected payment.
• Understands and adheres to revenue cycle’s escalation policy.
• Coordinates and supports multiple specialized tasks, functions, and/or roles to meet needs of accomplished tasks.
• Maintains knowledge of, and complies with all relevant laws, regulations, policies, procedures, and standards.
• Works cross-functionally with various departments to ensure alignment and efficiency with shared processes related to compliance.
• Identifies or assists with identifying internal or external data trends to evaluate outliers and areas of risk, and to enable process improvement.
• Organizes and performs reconciliations and identifies trends that need addressed while ensuring accuracy, quality, and compliance in designated work areas.
• Organization Expectations, as applicable:
• Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served.
• o Partners with patient care giver in care/decision making.
• o Communicates in a respective manner.
• o Ensures a safe, secure environment.
• o Individualizes plan of care to meet patient needs.
• o Modifies clinical interventions based on population served.
• o Provides patient education based on as assessment of learning needs of patient/care giver.
• Fulfills all organizational requirements.
• o Completes all required learning relevant to the role.
• o Complies with and maintains knowledge of all relevant laws, regulation, policies, procedures and standards.
• Fosters a culture of improvement, efficiency and innovative thinking.
• Performs other duties as assigned.

Required Qualifications

• Bachelor of Arts in Health Information Management or related field or, in lieu of a bachelor’s degree, 4 years of experience in applicable business-related field.
• 5 years in revenue cycle management
• RHIT, CCS, CPC, CCS-P RHIA, or CHC Upon Hire

Preferred Qualifications

• Master of Arts in applicable field or, in lieu of a master’s degree, 6 years of experience in applicable business-related field. Health Information Management or related field.
• 10 years in revenue cycle management