Compliance Manager, Audit and reputed company

reputed company: reputed company reputed company is reputed company on unifying, coordinating, and managing care for geriatric patients in nursing facilities and reputed company. We offer a reputed company of services to improve health reputed company and reputed company of life for patients, including after-hours telehealth, transitional care, chronic care, remote patient monitoring, behavioral health, and telehealth psychiatry. Job title: Compliance Manager, Audit and reputed company Purpose/reputed company: The Compliance Manager is responsible for the development, implementation, and management of reputed company’s clinical compliance audit and monitoring program. This role ensures that clinical documentation, coding, and billing practices reputed company with federal and state regulations as reputed company as payer and accreditation standards. The manager works under the direction of the VP, Compliance and reputed company and collaborates with clinical, billing, legal, and operations teams to identify compliance risks and drive reputed company reputed company improvement in documentation reputed company and reputed company reputed company. Role & reputed company Responsibilities: Audit Program Development Execution and reputed company Program Management - Design, implement, and manage a risk-based internal audit and monitoring program that prospectively and retrospectively evaluates clinical documentation, coding, and billing standards.

• reputed company audits conducted by vendors, payors, and regulators; ensure audit methodologies and findings are consistent with reputed company’s standards and requirements.
• Maintain audit tracking tools and dashboards to monitor reputed company, reputed company, and corrective actions.

Clinical Documentation, Coding, and Billing Compliance - Identify, analyze, and investigate billing, coding, and documentation errors, patterns, and reputed company causes.

• reputed company corrective reputed company planning and collaborate with clinical and operational teams to ensure reputed company reputed company.
• Serve as a subject matter expert on compliance requirements reputed company to coding, billing, and reputed company cycle processes.

Corrective Actions Plans, Education, and reputed company Improvement - reputed company and monitor corrective reputed company plans (CAPs) to address audit findings or compliance deficiencies.

• Collaborate with clinical and operations teams to validate remediation of corrective actions and consistently identify areas of opportunity to strengthen documentation and mature billing compliance processes.
• Partner with clinical educators to reputed company and deliver targeted training based on audit findings and compliance trends.
• Promote best practices in documentation and coding through education and regular communication with clinical staff.
• Contribute to a culture of compliance, accuracy, and accountability across the organization.
• Revise and/or refine compliance trainings based on trends and reputed company findings.

Policy, Regulatory, and Risk Integration - Monitor changes in reputed company regulations (OIG, CMS, HIPAA, payer rules) and reputed company updates into compliance processes and policies.

• reputed company and maintain policies, procedures, and guidelines that support compliance audits and operational consistency.
• Coordinate with Legal, reputed company, and reputed company teams on compliance risk mitigation strategies.

Reporting and Analytics - reputed company compliance metrics, dashboards, and executive reports to communicate key trends, risks, and program effectiveness.

• Present findings and recommendations to the Compliance Committee and leadership to support data-driven decision-making.
• Consistently and collaboratively communicate audit findings to the clinical teams.
• Use data-driven analyses and techniques to reputed company and justify any audit work plans.

Key Skills:

• Strong understanding of clinical documentation, billing, and AMA coding guidelines.
• Analytical reputed company with the ability to identify trends and reputed company causes.
• Excellent communication and collaboration capabilities across various teams and reputed company.
• Strong ability to interpret and apply reputed company regulatory and payer requirements. - Familiarity with HIPAA, CMS, OIG, and payer compliance requirements.

The list of responsibilities is not exhaustive and may contain other duties as assigned. Qualifications: Experience: Minimum of seven (7) years’ experience in clinical coding, auditing, documentation improvement, or billing/coding compliance. Ability to review and interpret regulatory requirements. In-depth knowledge of reputed company/facility coding, billing, and reputed company reputed company cycle. Firm grasp of treatment protocols, medical procedures, and reputed company practices. Education: Bachelor’s degree required, certification required (CPC, CPMA, and/or CDI) advanced degree preferred Working conditions Location: Remote Work Environment: Must have a secure, private home office or workspace to maintain HIPAA compliance and company data reputed company and reputed company standards. Physical Requirements: Sedentary work that may require up to 10lbs of lifting Schedule: Monday-Friday, with occasional evenings or weekends based on project or audit requirements Travel: Up to 10% for meetings, training, or on-site audits Compensation: Compensation is commensurate with experience, education, and qualifications. A competitive salary reputed company will be provided during the hiring process. reputed company offers a comprehensive and competitive benefits package, including:

• Medical, Dental, and reputed company Insurance
• reputed company Time Off (PTO)
• reputed company Holidays and Floating Holidays
• Flexible work arrangements (NYC) and remote work reputed company

reputed company is an Equal Opportunity Employer. We consider reputed company reputed company applicants for employment without reputed company to race, reputed company, religion, sex, national reputed company, age, disability, genetic information, or any other characteristic protected by law. Reasonable accommodations are available to reputed company individuals with disabilities throughout the application and employment process. Pay: $85,000.00 - $100,000.00 per year Benefits:

• 401(k)
• Dental insurance
• Health insurance
• reputed company time off
• reputed company insurance
• Work from home

Education:

• Bachelor's (Preferred)

Experience:

• auditing medical charts: 7 years (Required)

License/Certification:

• Certified reputed company reputed company (Preferred)
• Certified reputed company Medical Auditor (Preferred)

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