What are the responsibilities and job description for the Audit and Education Manager position at Gill Compliance Solutions, LLC.?
Company Description Gill Compliance Solutions (GCS) is a Northwest-based compliance support company serving providers in hospitals, health care systems, and independent physician practices. The organization focuses on creating long-term solutions and sustainable change rather than one-time consulting engagements. GCS is known for its relationship-oriented approach and many success stories that highlight its commitment to adding value, one provider at a time. The team specializes in specialty audits centered on professional documentation, coding, and regulatory compliance. In a changing health care environment, GCS emphasizes innovation, thorough review and analysis, and ongoing support to drive continuous improvement for medical practices.
Are you passionate about physician coding, compliance, and education?
Gill Compliance Solutions is growing, and we're looking for an experienced Audit & Education Manager (remote) to join our nationally recognized consulting team. Our consultants work directly with physician practices, hospitals, health systems, new tech, and legal firms across the country to defend providers, improve documentation, coding accuracy, compliance, and reimbursement. Every day presents new specialties, new challenges, and opportunities to make a measurable impact. If you enjoy educating providers, solving complex coding issues, presenting audit findings to executive leadership, and staying at the forefront of healthcare regulations, we'd love to meet you.
Duties may include but are not limited to the following:
- Managing and performing audits from electronic medical records initiated by a health care provider and ensures accuracy of diagnosis, procedure codes, and modifiers in accordance with Federal and State regulations in compliance with billing and coding guidelines.
- Navigate systems such as Epic, Cerner, Allscripts and other commonly used EHR's to conduct audits.
- Effectively manages assigned work using systems such as smartsheet and box.com.
- Review, analyze, and validates medical records documentation (CPT/HCPCS/ICD-10) to ensure completeness and accuracy of code selections while identifying educational opportunities for client.
- Prepares educational materials to communicate with providers when identifying gaps in clinical documentation for the selection of appropriate diagnosis, procedures, and modifiers.
- Conducts provider and coder training and on-going education on billing and coding guidelines, modifiers, and payor policy. Remains current with regulatory guidelines for billing and coding including health plans and coding updates.
- Review and analyzes questions around denials, rejected claims, coding, payor rules, and compiles training materials to educate and the support the client.
- Reviews and responds to clients questions around coding, regulatory compliance, payor policies.
- Work with CEO and legal counsel to audit documentation and data mining to defend clients.
Job Requirements
We're looking for someone who has:
- CPC/CCS/CCS-P or CPC certification(s) (required) and other speciality specific certifications
- Five or more years of physician coding audit experience
- Granular expertise in all E/M, and surgical specialties such as Orthopedics, Urology, General Surgery
- Strong CMS and Medicare regulatory knowledge, especially Noridian
- Experience educating physicians and clinical staff and coders
- Excellent presentation, communication, and savvy writing skills
- A passion for helping healthcare organizations succeed
Benefits:
- Flexible schedule and opportunity for a 4 day work week / Health Insurance / Retirement Plan / Generous Time off / Phone allowance / Gym Membership / Paid CEU's / Bonuses
- Excellent professional recommendations are required - Salary DOE
- Send letter of interest / Resume to lisa.mackenzie@gillcompliance.com