Compliance Manager, Provider Audit And Education
CurrentDevelop, implement, maintain and update written policies and procedures and standards of conduct. Create and manage effective compliance training and education initiatives. Streamline open lines of communication for reporting compliance issues or concerns, including managing organization-wide compliance hotlines. Provide compliance and privacy investigations, including root cause analysis and corrective action plans. Perform rigorous internal coding audits, ensuring appropriate CPT assignment, ICD-10 specificity, and HCPCS Level II/modifier usage. Adhere, process, confirm and oversee RADV, RAC, PDV and other audit findings performed by CMS, Medicaid, VA, Tricare, and commercial payers. Initiated and implemented the Compliance Audit and Education Program to promote coding accuracy, physician documentation improvement, and provider/coder education.Lead the internal Certified Professional Coding course for non-certified coders throughout more than 15 states.