3 medical compliance specialist 2 jobs found in Miami, FL

Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet. The Medical Compliance Specialist 2 is part of the compliance team and promotes healthcare compliance within UHealth. The incumbent is responsible for conducting research, performing audits, monitoring and investigations, documentation reviews of the UHealth policies, rules and regulations. Additionally, he/she will contribute to the success of the compliance program by strategizing compliance risk assessment, summarizing and documenting compliance related UHealth policies and procedures, while maintain accurate records of division actions and will document communication with members of the medical community, regulatory entities and any others involved in the medical enterprise. CORE...

Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here (https://www.myworkday.com/umiami/d/task/1422$7248.htmld) to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER_eRecruiting_ApplyforaJob.pdf) . The Medical Compliance Specialist 2 is part of the compliance team and promotes healthcare compliance within UHealth. The incumbent is responsible for conducting research, performing audits, monitoring and investigations, documentation reviews of the UHealth policies, rules and regulations. Additionally, he/she will contribute to the success of the compliance program by strategizing compliance risk assessment, summarizing and documenting compliance related UHealth policies and procedures, while maintain accurate records of division actions and will...

; ; Summary: Reviews medical record documentation to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing and compliance. ; Detailed responsibilities: •Reviews encounters to assign and sequence appropriate diagnoses and procedure codes as well as modifiers to complex diagnostic and surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures. •Using encoder, reviews Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG) assignments. Reviews coding edits. Reviews Local Coverage Determination (LCD) edits and guidance for codes meeting medical necessity. Researches electronic medical record for any additional diagnoses documented to meet medical necessity. •Seeks clarification from healthcare providers or other designated resources...