Senior Healthcare Compliance Officer, Revenue Cycle Management

Company Description

Vee Healthtek, Inc. delivers cutting-edge solutions that transform healthcare organizations. We offer a comprehensive suite of services that leverage our industry expertise to provide the best value to our clients. Through close collaboration and a deep understanding of market trends, we create customized strategies that deliver tangible outcomes. Our technology-driven services empower organizations to thrive in the evolving healthcare landscape, resulting in improved workflows, increased cost efficiency, and streamlined business processes. Learn more at www.veehealthtek.com.

Role Description

The Senior Healthcare Compliance Officer ensures that the global organization’s revenue cycle management operations comply with all applicable healthcare laws, regulations, and ethical standards across jurisdictions. This role is critical in maintaining regulatory integrity, mitigating risk, and fostering a culture of compliance in a fast-paced, rapidly organization. This is a fully remote position with travel as needed. 

Key Responsibilities

• Policy and program development: Designs, implements, and manages the organization's revenue cycle compliance program. This includes creating and updating policies and procedures related to patient billing, coding, and documentation.
• Risk assessment: Conducts regular risk assessments to identify potential vulnerabilities within the revenue cycle. This involves analyzing processes related to patient intake, charge capture, and account receivables to detect potential issues before they lead to violations.
• Auditing and monitoring: Oversees and conducts internal audits of billing records and medical documentation to ensure compliance with payer requirements, such as Medicare, Medicaid, and private insurers. They also review data for improper coding, modifiers, and documentation standards.
• Training and education: Develops and delivers compliance training programs for staff, including billing and coding specialists, as well as clinical and administrative teams. This ensures employees are up-to-date on regulatory changes and best practices.
• Investigating issues: Investigates reported or discovered compliance issues, documenting findings, and reporting potential violations to leadership. They may also work with human resources to determine appropriate disciplinary action for non-compliance.
• Regulatory communication: Acts as the primary liaison with external regulatory bodies and government agencies, responding to inquiries, audits, and investigations.
• Corrective action: Develops and tracks corrective action plans to address compliance deficiencies, following up with management to ensure successful implementation.
• Reporting: Creates and presents periodic compliance reports to leadership detailing auditing activities, findings, risk levels, and the status of corrective actions. 

Qualifications:

• Education: A bachelor's degree in a related field such as business administration, finance, or healthcare management is often preferred, but not always required.
• Regulatory knowledge: In-depth knowledge of healthcare regulations and laws, including HIPAA, CMS guidelines, and state-specific billing requirements.
• Coding expertise: Advanced knowledge of medical coding, including CPT, HCPCS, and ICD-10.
• Analytical skills: The ability to analyze complex data sets from audits and financial reports to identify trends, pinpoint issues, and generate actionable insights.
• Communication skills: Excellent written and verbal communication to explain complex regulatory information, create clear policies, and report findings to various stakeholders, from billing staff to senior leadership.
• Leadership: The ability to lead teams and influence cross-functional departments to adopt and maintain a culture of compliance.
• Attention to detail: A keen eye for detail is essential for reviewing documentation, policies, and regulations to ensure all requirements are met.