We are representing a large award-winning healthcare company in their search for a Director Healthcare Regulatory, Billing and Coding Compliance in Dallas, TX.
Why Join Us:
- healthcare group with over 48,000 employees and net revenues exceeding $9 billion
- Company has received multiple awards for Best Workplaces, Diversity and Excellence in Healthcare Delivery
- Opportunity to work directly with executive compliance team in strategy and development of the program
- Culture based on innovation, success and collaboration
Expectations first 12 months:
- Assist in ongoing compliance risk assessment of billing and coding programs, identifying areas of weakness and developing solutions and improvements
- Establishing strong working relationships with stakeholders within and outside of governance teams
- Evaluate current scope of work and identify efficiency and enhancement opportunities using data analytics
Responsibilities:
- Reporting to the VP Compliance, managing a team of 21 including indirect reports, direct hospital billing compliance audits and investigations, regulatory research and employed physician coding audit functions
- Identify and evaluate emerging compliance risks, utilizing regulatory guidance, resources, and data analytics on an ongoing basis to implement leading billing compliance practices
- Establish partnerships with key members of management to evaluate and address compliance issues and physician coding audit issues on an ongoing basis, and develop and lead completion of annual work plans
- Direct a coordinated physician compliance program; Actively participate as a compliance resource and consultant for physicians, mid-level providers, practice administrators and other physician practice staff
- Plan and direct compliance audits to assess compliance with system policies/procedures and regulatory requirements; prepare and communicate audit findings, conclusions, and recommendations
- Lead or directs both governmental and sensitive investigations with guidance from Legal Department
- Routinely perform regulatory research and provide written guidance to business partners on regulatory changes
- Develop and present Physician Coding Compliance progress and summary reports or presentations
- Promote consistency in the physician coding audit and education processes
- Develop and maintain a multidisciplinary team to evaluate CMS and governmental document requests, audits, and denials to evaluate for systemic concerns or necessary process changes
- Track the resolution of corrective actions in response to both compliance audits or investigations, or physician coding audits and provides summary reports of activity
- Define departmental goals and objectives providing leadership and guidance in selection, training, motivation, and professional development of subordinate compliance professionals
Requirements:
- Education: Bachelor’s degree
- Desirable: Healthcare Compliance Certification (e.g. CHC)
- Significant experience as a compliance professional in healthcare delivery – including demonstrable advanced knowledge of CMS billing regulation, revenue cycle and physician coding
- Proven people management skills in a large complex business
Relocation Policy:
Comprehensive relocation package available for qualified candidates, remote working option not available
Application Process for Director Healthcare Regulatory, Billing and Coding Compliance
Qualified professionals are to submit resume or interest to Steve Harrison at: steve@conselium.com
Published by Conselium Executive Search, the global leader in compliance search.
