|Employer:||Boston Children's Hospital
|Required Certifications:||CCS-P),Professional Billing Coding certification (CPC
|Required Experience:||3 to 4 years
|Location:||300 Longwood Ave Boston 02115, MA, US
At Boston Children’s Hospital, success is measured in patients treated, parents comforted and teams taught. It’s in discoveries made, processes perfected, and technology advanced through major medical breakthroughs and small acts of kindness. And in colleagues who have your back and patients who have your heart. As the teaching hospital of Harvard Medical School, our reach is global and our impact is profound. Join our acclaimed Department of Compliance organization and discover how your talents can change lives. Yours included.
This Hospital Billing Compliance Manager will :
To qualify, you must have:
- Work in concert with the Director of Billing Compliance to develop and manage the Hospital Billing Compliance program for the Boston Children’s Hospital enterprise as defined through the annual Hospital Billing Compliance work plan. This exciting opportunity includes working with 2 hospital billing compliance auditors to oversee
- Identify high risk hospital billing compliance areas to review and design and perform hospital billing compliance audits based on billing compliance risk areas
- Develop systems to monitor the quality and effectiveness of coding and documentation practices and recommend and implement changes to ensure billing compliance
- Maintain knowledge of current regulatory and compliance guidance and awareness of issues and risk areas related to billing and reimbursement
- Be a department representative on Hospital Committees that address coding and billing and working collaboratively with representatives from BCH Clinical Departments, Revenue Integrity, HIM Coding, Patient Financial Services, Case Management and Pricing
- Utilize auditing software to perform hospital billing compliance audits
- Follow up on audit findings with key stakeholders through training and education and/or recommendation of system and/or workflow modifications
- Perform education sessions to Departments on hospital billing compliance
- Function as a key resource to advise on responding to external audits being performed of BCH services (e.g. Federal, State and Third party payer audits)
- The level of knowledge typically acquired through completion of a Bachelor’s degree in Health Information Management or Nursing and three to four years of medical coding or reimbursement experience such as ICD-10 and CPT coding
- Successfully attained the level of being a subject matter expert on hospital billing compliance
- The ability to be self-motivated, detail oriented and a collaborative and consummate team player
- The analytical skills to collect information from diverse sources, apply professional principles in performing various analyses, and summarize the information and data in order to solve problems or design relatively complex systems and programs that cross department/divisional lines
- Communication skills in order to effectively deal with conflicting views or issues and mediate fair solutions, and well-developed writing skills
- Professional Billing Coding certification (CPC, CCS-P) required. RN, CSS, RHIT/RHIA, ART/RRA, preferred
Boston Children’s Hospital offers competitive compensation and unmatched benefits, including an affordable health, vision and dental insurance, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition Reimbursement, and discounted rates on T-passes (50% off). Discover your best.
Boston Children’s Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.