Compliance Analyst
For over 30 years, Cirius Group, Inc. has been
dedicated to producing efficient, quality healthcare software products and
services. Cirius Group provides
results-driven, revenue cycle management and improvement solutions to
hospitals, clinics, labs, physicians groups, and other healthcare
providers. We offer a full spectrum of
highly-efficient software tools for claims, reimbursement, remittances and
denial management.
With
minimal supervision, the candidate is responsible for the development and
maintenance of multiple payer specific edit packages. Candidate will report to
the Director of Compliance.
Responsibilities
include but are not limited to:
• Development, testing and deployment of standard edit packages.
•
Works closely with clients informing them of current billing
regulations/changes.
•
Assists as requested with staff development and team building.
•
Identifies trends and opportunities for additional training, education and
improvement.
•
Keeps abreast of all current billing and coding rules and regulations affecting
both government and non-government payers.
• Some
travel to client sites for onsite compliance reviews.
Education and Experience
• Coding certification (CPC or CPMA) preferred
from a nationally recognized professional association (AAPC, AHIMA).
• High school diploma or GED equivalent required. Bachelor’s degree preferred.
• Proven knowledge of CPT-4, HCPCS, ICD-9 & ICD-10 coding required
• Knowledge of UB04 and 1500 claim forms
• Knowledge of Medicare, Medi-Cal, Out of State Medicaid(s), Commercial, and
Managed Care insurance guidelines preferred.
Knowledge/Skills:
• Excellent organizational skills, thorough
follow through and the ability to work independently with minimal supervision
and maintain confidentiality in all activities.
• Excellent computer skills, including MS Excel, Word, and PowerPoint.
• Excellent written and verbal communication skills.
• Works with multiple software applications, including word processing,
database management, spreadsheets, graphics and presentation software,
electronic calendar and email.
• Accessing State and Federal websites for coding and billing regulations.
• Ability to troubleshoot, identify problem areas, develop and implement
solutions.