Sr Billing Compliance Specialist

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Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.

At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care-and your career.

CHOP does not discriminate on the basis of race, color, sex, national origin, religion, or any other legally protected categories in any employment, training, or vendor decisions or programs. CHOP recognizes the critical importance of a workforce rich in varied backgrounds and experiences and engages in ongoing efforts to achieve that through equally varied and non-discriminatory means.

A Brief Overview
Assists the Senior Director with reviewing and analyzing billing processes and conducting auditing and monitoring to ensure compliance with applicable healthcare regulations. Assist Director with ongoing projects and provides guidance to departmental staff.

What you will do

• Assist the Director in projects and investigations
• Manage departmental projects and special audits completed by the Department
• Responsible for maintaining all coding guidelines; create and/or review annually
• Assists with compliance auditing process, including developing audit plans, conducting audits or managing the conduct of audits, reporting results and making recommendations for improvement
• Assists in the development of education & training
• Monitors Federal and local statutes and regulatory changes and makes recommendations for process improvement
• Researches and analyzes compliance issues utilizing various publications including extensive use of the internet, the Federal Register, the Medicare Carriers Manual, and other industry publications; makes recommendations for process improvements, and monitors corrective action plans
• Provide guidance to OCP compliance staff and to billing and other staff across the institution, as directed by the Senior Director
• Maintain MD Audit software; troubleshoot issues
• Participates in assigned organization committees
• Perform other duties or special projects to support the billing compliance program, as required

Education Qualifications

• High School Diploma / GED - Required
• Bachelor's Degree healthcare, business, communications, education law or related field - Preferred

Experience Qualifications

• At least ten (10) years related experience - Required

Skills and Abilities

• Knowledge of Microsoft Office Suite including PowerPoint, Excel and Access; internet research skills.
• Excellent communication and interpersonal skills required. Must be able to communicate with physicians, senior administrators and office staff.
• Excellent organizational skills.
• Analytical abilities.
• Excellent written and oral presentation skills.
• Eagerness to learn new areas and work with little supervision.
• Good judgment.
• Ability to work with confidential materials and to juggle multiple tasks.

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must receive an annual influenza vaccine. Learn more.

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SALARY RANGE:

Salary ranges are shown for full-time jobs. If you're working part-time, your pay will be adjusted accordingly.

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At CHOP, we are committed to fair and transparent pay practices. Factors such as skills and experience could result in an offer above the salary range noted in this job posting. Click here for more information regarding CHOP's Compensation and Benefits.