RN Compliance Analyst Clinical Job Listing at MedStar Medical Group in Washington, DC (Job ID req41097)

Description

Assists the MedStar Family Choice (MFC) compliance and privacy programs. Conducts both internal and external audits to ensure compliance with regulatory requirements. We recruit, retain, and advance associates with diverse backgrounds, skills, and talents equitably at all levels.
Education

• Bachelor's degree in Nursing preferred

• 3-4 years Clinical experience in an acute care setting; experience in medical record review; 3 years experience in performing internal or external clinical audits and reviews in support of regulatory compliance initiatives required and
• Experience in health care compliance preferred

• RN - Registered Nurse - State Licensure and/or Compact State Licensure Valid RN license in the jurisdiction of the health plan. required and
• CCS-Certified Coding Specialist At least one coding credential preferred: Certified Coding Specialist (CCS), Certified Coding Associate (CCA) or Certified Professional Coder (CPC). preferred

• Must possess excellent organizational skills, including the ability to prioritize multiple tasks and perform them both accurately and simultaneously.
• Strong analytical and attention to detail skills.
• Ability to work with minimal supervision, guidance and direction.
• Knowledge of MS Office (Word, Excel, PowerPoint and Outlook).
• Proficient knowledge of Medicaid, Medicare and other third party payer requirements pertaining to documentation, coding, billing and reimbursement.
• Proficient on performing E/M reviews.
• Strong knowledge of health care regulations related to reimbursement and coding.
• Excellent verbal and written communication skills.
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
• Ability to establish and maintain positive and effective work relationships with members, providers, vendors and co-workers.