- Professional
- Escritório em Nashville
JOB SUMMARY:
The Compliance & Billing Analyst ensures physician billing practices comply with regulatory and payer guidelines by assisting in conducting compliance audits and testing CPT codes for new test setups. This role works closely with the Director of Coding & Compliance to ensure day-to-day billing processes are accurate, efficient, and compliant.
JOB RESPONSIBILITIES
ESSENTIAL FUNCTIONS:
- Gather and review required documentation to perform physician compliance audits, ensuring billing accuracy and adherence to regulations.
- Collaborate with coding and compliance teams to implement audit findings and corrective actions.
- Maintain accurate documentation of audit results, rule changes, and supporting references.
- Analyzing billing data to identify trends and patterns that may indicate non-compliance.
- Conduct MDI testing with CPT codes in the billing system.
- Creating and implementing internal controls to ensure compliance with billing standards.
- Developing and delivering training programs to educate staff on billing compliance requirements.
- Providing ongoing support and guidance on billing compliance matters.
- Communicate relevant issues or updates to the supervisor, manager, or other designated individuals.
- Support a positive work environment and contribute to departmental and company goals.
- Follow industry best practices and regulatory guidelines to protect the confidentiality, integrity, and availability of protected health information and sensitive company data.
- Perform all job responsibilities in alignment with the industry’s best security practices and regulatory guidelines to protect the confidentiality, integrity, and availability of protected health information and other sensitive company data.
- Must be familiar with and abide by the Corporate Compliance Program and all Corporate policies, including the Privacy and Security policies.
NON-ESSENTIAL FUNCTIONS:
- Work with other departments within PathGroup and subsidiaries.
- Nothing in the job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.
- Other duties as assigned.
