Manager Compliance - Physician Services

Location

Westlinks – 12801 Westlinks Drive, Fort Myers, FL 33913

Department

Compliance

Work Type

Full Time

Schedule

Shift 1: 8:00 AM – 4:30 PM

Pay

$38.48 – $50.01 per hour (minimum to midpoint)

Summary

Plans and implements key initiatives for the compliance program related to physicians, advanced providers, coding, billing, and reimbursement. Identifies and investigates potential compliance concerns and provides guidance and education to operational staff. Contributes to the development of the biannual compliance risk assessment and work plan for physician services. Supervises Compliance Analysts and leads physician‑compliance investigations as delegated by the System Director, Compliance Audit & Investigation.

Responsibilities

• Plan and implement key initiatives for the compliance program concerning physicians, advanced providers, coding, billing, and reimbursement.
• Identify and investigate potential compliance concerns.
• Provide compliance guidance and education to operational staff on professional coding, billing, documentation, and reimbursement activities.
• Contribute to the development of the biannual compliance risk assessment and work plan for physician services.
• Supervise the daily work of Compliance Analysts.
• Serve as team leader for physician‑compliance investigations delegated by the System Director, Compliance Audit & Investigation.

Requirements

• Education: Bachelor’s degree required; Master’s degree preferred.
• Experience: Minimum 3 years in healthcare coding, billing, and reimbursement (required); 3 years in compliance (preferred).
• Certifications: Certified Professional Coder (CPC) required; Certified Healthcare Compliance (CHC) required.
• License: Not applicable.

Skills

• Ability to work effectively and collaboratively with individuals at any leadership level.
• Professional judgment to plan and accomplish goals.
• Capability to perform a wide variety of tasks.
• Resilience and flexibility in a fast‑paced environment of growth and change.
• Extensive knowledge of compliance rules and regulations in professional coding, billing, and reimbursement.
• Extensive knowledge of payment concepts, including ICD‑10, CPT, and managed‑care capitated arrangements.
• Extensive knowledge of the EPIC electronic medical record system for compliance review.
• Ability to support upper management in decision‑support roles through development of management information.
• Ability to coordinate activities of outside consultants while respecting attorney‑client privilege and work‑product doctrine.
• Ability to supervise and lead teams toward goal accomplishment.
• Proficiency in Microsoft Office for analysis and report generation.