Trainer Jobs in Maryland

Job Title: Compliance Specialist Trainer Company: Johns Hopkins University Location: Baltimore, MD Description: General Description:Provides on-going training and support to physicians, non-physician providers, professional fee billing staff, clinic staff, administrators, principal investigators, research coordinators, and other personnel on third party payer documentation and billing requirements for standard of care and research patient care billing. Using auditing and analysis techniques, determines the adequacy of medical records documentation, coding and billing for all providers across all clinical specialties. Works in close collaboration with the clinical departments, Physicians Billing Service and the Johns Hopkins Health System Compliance Office. The documentation audits are conducted as part of the School of Medicine?s Billing Quality Assurance Program. Prepare reports for the Senior Director, Director, and clinical departments regarding the status or results of the reviews. Summary results are presented to the Clinical Practice Association?s Board of Governors, the University?s Trustee Committee for Audits and Insurance and other appropriate offices within the School of Medicine or Johns Hopkins Medicine. Note: The significant difference between the Lead Compliance Specialist/Trainer position is the person in this role will provide oversight, training, guidance and/or assistance to other Compliance Specialist/Trainers or Compliance Auditors in the daily routine tasks of their position, under supervision of the Director. The Leads will collaborate with each other and the Director to assure consistent quality performance between and among all Compliance Specialists and Auditors. The Lead position will also be responsible for balancing work load, assuring that responsibilities of the group are completed within established time frames and making recommendations to improve workflow, process and productivity. The lead position will not have hiring or firing authority, but will have input to and assist in performance evaluations and improvement actions. Essential Job Functions of Compliance Specialists/Trainers - Conducts independent reviews/audits on the adequacy of medical record documentation to support the codes selected by providers or by billing office coders. - Verifies and corrects as necessary, the audit work completed by the Compliance Auditors or other Compliance Specialists. - Analyzes documentation or coding patterns by a provider, division or department that poses a compliance risk and recommends solutions to address the problem(s). - Assists departments and providers in developing corrective action plans to improve documentation practices, address compliance problems, or improve professional fee billing activities. - Conducts training sessions for providers, professional fee billing staff and others on a regularly scheduled or ad hoc basis. - Provides feedback to providers on the results of their medical record documentation reviews and gives targeted training as needed. - Researches and answers billing and documentation questions or problems submitted by faculty, departments, billing staff, and others to ensure compliance with specific payer regulations and School of Medicine / Clinical Practice Association policies and procedures. - Regularly monitors potential billing problems and/or billing errors identified by each departments? professional fee billing office. - Prepares and revises as needed a Compliance Training Manual for routine and special training programs. - Assists in the development of medical record documentation standards and requirements related to clinical services billing. - Keeps current with third party regulations with emphasis on Medicare billing, teaching physician regulations, Current Procedural Terminology, ICD-9-CM Coding, and professional fee billing. - Perform other compliance related activities as necessary. Essential Job Functions Of Lead Compliance Specialist/Trainers - Serves as a working Lead, performing the above job functions in addition to the following responsibilities. - Trains or assists in training new Compliance Specialist/Trainers or Auditors to ensure uniformity and quality of work. This includes the performance of the documentation reviews, conducting individual and group training sessions, using appropriate resources to research questions from providers and billing staff, and use of audit software. - Meets regularly with other Compliance Specialist/Trainers or Auditors to review the progress of work and address any impediments to meeting deadlines. Provides regular updates and presents issues that require management involvement to the Director. - Assigns work and balances work load, adjusting priorities in consultation with the Director. With the Director, sets productivity goals and quality standard for the Specialists or Auditors and produces or reviews reports to monitor progress. - Assists in training physicians, other clinicians, billing office staff and others on the clinical documentation and coding requirements for professional fee billing. - With the Director, establishes a protocol to collaboratively work with the CPA?s Physicians Billing Service and JHHS?s Compliance Office to investigate and resolve billing complaints, operations issues or errors that impact hospital and professional fee billing. - Ensures the quality of the audit work and reports prepared by the Specialists or Auditors under his/her responsibility. - Prepares and revises policies and procedures for the Specialists and Auditors. - Performs other compliance related activities as necessary. Qualifications:Bachelor?s Degree in health care-related or business-related field, or five years of recent, direct experience with third party payer requirements for physicians required. Medical Terminology and Anatomy and Physiology courses or demonstrated appropriate knowledge required.Two years of auditing/billing compliance experience required. A Master's Degree in a health care related discipline may be substituted for up to one year of experience. Additional years of related experience performed as a consultant with a recognized organization may be substituted at the rate of one year consultancy for two years of other experience. Recent experience with Medicare regulations required. A minimum of one professional coding certification required (CCS-P, CPC, RHIA or RHIT). Must maintain certification throughout duration of employment. Requires a detail-oriented individual with the ability to handle a high volume of multiple tasks and follow through to completion. Must be able to learn quickly and work independently to address a variety of complex issues. Must be flexible to adjust to the development and refinement of new processes and procedures. CPT and ICD-9 coding required, including coding from clinical documentation or auditing the coding of others. Extensive knowledge of Medicare?s regulations regarding clinical research coverage, teaching physicians and documentation guidelines, and other federal and state laws and regulations concerning clinical documentation, coding, and reimbursement required. Demonstrated communication, analytical and organizational skills are essential. Demonstrated training or teaching experience required. Proficient in Microsoft Office applications including Excel and Word, Outlook or equivalent e-mail, and internet usage required. Must be self-motivated and comfortable working independently, as a team leader and as a team member required. Five years auditing/billing compliance experience preferred. Knowledge of related clinical and business practices, policies, and procedures for billing and collection of professional fee services, and audit processes preferred. Experience with IDX Billing and Accounts Receivable system, EPR, and other clinical information systems preferred. Previous lead or supervisory experience preferred for Lead position. Additional coding certifications preferred.Job Type: Full Time