Reports to the Director of Coding/Compliance/HIM and is responsible for leadership, guidance, and supervision of the staff assigned to MSO services. Responsible for leading the auditing and compliance functions, ensuring that regulatory requirements and hospital policies are maintained. The person in this role provides guidance, advice, and leadership to resolve complex and critical issues, ensuring that the MSO services maintain the highest level of compliance while still meeting the needs of patients, physicians, and staff. Develops training and education providers to achieve compliance with all documentation and coding guidelines.

The Manager demonstrates strong leadership skills, a sense of urgency, and is proactive in their approach. The person will demonstrate effective decision making, judgment, communication, and modeling of the Atlantic Health System (AHS) mission and the Trusted Network of Caring.

• Provide coding and billing assistance to MSO services to increase understanding of compliance regulations based on findings from billing and patient records.

• Oversee auditing processes ensuring the performance of internal audits for MSO providers/practices. Evaluation all CPT/procedures codes utilized for accuracy and consistency with CMS guidelines. Provision of training and education to address coding/compliance issues.

• Provide Auditing/Coding/Compliance assistance to MSO services to increase understanding of compliance regulations; based on workflow assessment results. Initiate provider/practice training opportunities to review and educate on results

• Manage and educate new staff on EMR systems, auditing processes, policies and procedures.

• Remain current on federal and state regulations changes.

• Provide education to physicians and staff regarding the compliant use of technology; as well as, participate in the implementation and maintenance of technical systems (EMR, Billing System, devices, etc). Continually serve as a resource for education, training, guidance, and build of clinical applications.

• Update MSO services of any new coding or compliance rules, CPT changes, HCPCS changes, ICD-10 changes.

• Manage, educate, and orient new staff regarding policies & procedures, audit rules and systems used by the department.

• Report compliance data to external agencies such as the Centers for Disease Control and Prevention (CDC) and Centers for Medicare & Medicaid Services (CMS)

• Work with third-party payers and agencies to comply with audits

Required:

Education: Knowledge of Epic systems. Five years of auditing/compliance/coding experience, preferably in for a large physician practice group. CPC certification required.

Knowledge: Knowledge of healthcare/ambulatory care management. Must be familiar with High level proficiency of medical terminology, anatomy and physiology, medical treatment methods, patient care assessment, and medical documentation guidelines required.

Skills: Possesses a professional manner and has communication and interpersonal skills necessary to handle sensitive and confidential situations with poise, tact and diplomacy. Ability to interact with diverse groups of people both within and outside of the corporation. Demonstrated written and verbal communication skills. Effective organizational and time management skills necessary to manage and prioritize multiple tasks and projects.

Work Experience: Five years of auditing/compliance/coding experience, preferably in for a large physician practice group.

ABOUT US

At Atlantic Health System, our promise to our communities is; Anyone who enters one of our facilities, will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 20,000 team members. Headquartered in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include:

• Morristown Medical Center, Morristown, NJ

• Overlook Medical Center, Summit, NJ

• Newton Medical Center, Newton, NJ

• Chilton Medical Center, Pompton Plains, NJ

• Hackettstown Medical Center, Hackettstown, NJ

• Goryeb Children's Hospital, Morristown, NJ

• CentraState Healthcare System, Freehold, NJ

• Atlantic Home Care and Hospice

• Atlantic Mobile Health

• Atlantic Rehabilitation

We also have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group. Atlantic Accountable Care Organization is one of the largest ACOs in the nation, and we are a member of AllSpire Health Partners.

We have received awards and recognition for the services we have provided to our patients, team members and communities. Below are just a few of our accolades:

• 100 Best Companies to Work For ® and FORTUNE® magazine for 15 years

• Best Places to Work in Healthcare - Modern Healthcare

• 150 Top Places to work in Healthcare - Becker's Healthcare

• 100 Accountable Care Organizations to Know - Becker's Hospital Review

• Best Employers for Workers over 50 - AARP

• Gold-Level "Well Workplace": Wellness Council of America (WELCOA)

• One of the 100 Best Workplaces for “Millennials” Great Place to Work® and FORTUNE® magazine

• One of the 20 Best Workplaces in Health Care: Great Place to Work® and FORTUNE® magazine

• Official Health Care Partner of the New York Jets

• NJ Sustainable Business

  EEO STATEMENT

  Atlantic Health System, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran status.