Sr. Compliance Coordinator-Billing & Coding

We need to output HTML fragment with sections: h3 for headings like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. The posting includes: Additional Information About The Role (some bullet-like sentences). Overview (description). Role Purpose (maybe part of About the role). Responsibilities (list). Minimum Requirements (Education, Experience, etc). Preferred Qualifications (Education, Licenses & Certifications). Benefits And Legal Statement (benefits). No explicit Pay or Schedule. So we should include sections: About the role (maybe combine Additional Information + Overview + Role Purpose). Responsibilities. Requirements (maybe Minimum Requirements). Qualifications (Preferred Qualifications). Benefits. No Pay or Schedule. Also Skills? There's mention of Working knowledge of EXCEL and MS Publisher, analyzing provider data, training on billing guidelines, auditing experience, etc. Could be under Skills. But we can incorporate into Requirements or Qualifications. However we need to follow rule: Use h3 for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). We should include sections only when posting has real specific content. So we can have About the role, Responsibilities, Requirements, Qualifications, Benefits. Possibly Skills if we extract. Let's see content: "Additional Information About The Role Remote opportunity! Experience with analyzing provider data and training on current billing guidelines to identify trends is a plus! Previous auditing experience of evaluation and management and surgical procedures is preferred! Working knowledge of EXCEL and MS Publisher." That's skills. Also "Overview ..." is about the organization. "Role Purpose ..." describes purpose. Could be part of About the role. So we can combine. Responsibilities: long list. Minimum Requirements: Education High School Diploma or GED, Experience 5-10 years, Supervisor Experience No Experience, Licenses & Certifications CCS/CPC Preferred. Preferred Qualifications: Education Associate's Degree Business/HC Admin/related, Licenses & Certifications RHIA/RHIT. Benefits: list. Thus we can have sections: About the role (includes remote opportunity, overview, role purpose). Responsibilities. Requirements (minimum). Qualifications (preferred). Benefits. We must not repeat job title. No Job ID. We must not include boilerplate like Equal Opportunity Employer, legal statements, etc. Remove that. We must preserve all substantive information; do not invent or summarize away detail. So we need to keep details like "Remote opportunity!", "Experience with analyzing provider data and training on current billing guidelines to identify trends is a plus!", etc. Must keep them. We need to format as HTML fragment: use

for headings,

• for lists,

  for prose. We need to decide what goes into lists vs prose. For responsibilities, it's a list of duties; we can make

  • each responsibility sentence. For requirements: Education, Experience, etc. Could be list. For qualifications: list. For benefits: list. For About the role: could be prose paragraphs. Let's extract details precisely. From posting: Additional Information About The Role - Remote opportunity! - Experience with analyzing provider data and training on current billing guidelines to identify trends is a plus! - Previous auditing experience of evaluation and management and surgical procedures is preferred! - Working knowledge of EXCEL and MS Publisher. Overview BJC Medical Group is the multi-specialty physician-led organization of BJC HealthCare and includes over 600 doctors and advanced practice providers who are affiliated with top-ranked hospitals in the Midwest region. Since 1994, BJC Medical Group has provided access to extraordinary care in over 145 locations and over 25 specialties in the greater St. Louis, mid-Missouri and southern Illinois areas. Our providers are nationally recognized for excellent patient satisfaction, quality health care, and improving the health and well-being of the communities we serve. The Quality and Compliance Department provides support to the strategic and operational objectives of BJC Medical Group practices is located in Town & Country, MO. Role Purpose The Senior Compliance Coordinator conducts and coordinates reviews of BJCMG specialty provider documentation to ensure accuracy of services billed. This position prepares reports of findings to be presented to providers. This position also develops educational opportunities for new and existing providers giving instruction on federal and state regulations, documentation guidelines, and coding training in a way that ensures compliance with governmental regulations. Additionally, the Senior Compliance Coordinator collaborates with departments in providing appropriate education to staff as it relates to compliance and privacy of protected health information. Responsibilities (list): - Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services identified as part of the review for specialty providers or up on request from management. - Interacts with specialty providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation based on the review. - Develops and/or presents educational training material to specialty providers and coders based on findings and trends identified as a result of the reviews; provides general education on coding and documentation rules and regulations, regulatory provisions, and third party payer requirements to new employees and providers to include Employee and Provider New Employee Orientation. - Interacts with government agencies/contractors, management, employees and others, as necessary, to ensure an understanding of the organization’s compliance initiatives. - Conducts and coordinates routinely scheduled reviews of BJCMG specialty providers' documentation involved with professional fee billing for accuracy of coding and physical presence; reviews consist of ambulatory E&M services and office procedures, as well as hospital admissions, subsequent visits, hospital procedures, and all other services performed by BJCMG specialty providers; reviews medical record documentation to identify under-coded and up-coded services, prepares reports of findings, and meets with providers to provide education and training on accurate coding practices and compliance issues; serves as subject matter expert related to specialty coding. - Conducts focused reviews across the BJCMG enterprise based upon the Compliance Department's annual work plan and/or trends identified based upon internal reviews or requests from senior leadership; performs special projects as requested/assigned by management; monitors trends across the organization and develops education and training on accurate coding practices and compliance issues. - Provides guidance and serves as mentor to fellow coordinators related to the audit process, coding, billing and compliance; identifies and notifies management educational opportunities and/or concerns as a result of serving as lead auditor. - Support the HIPAA liaison by tracking and conducting employee investigations when requested. Minimum Requirements: Education: High School Diploma or GED Experience: 5-10 years Supervisor Experience: No Experience Licenses & Certifications: CCS/CPC Preferred Preferred Qualifications: Education: Associate's Degree Business/HC Admin/related Licenses & Certifications: RHIA/RHIT Benefits And Legal Statement: BJC Total Rewards At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being. Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date Disability insurance* paid for by BJC Annual 4% BJC Automatic Retirement Contribution 401(k) plan with BJC match Tuition Assistance available on first day BJC Institute for Learning and Development Health Care and Dependent Care Flexible Spending Accounts Paid Time Off benefit combines vacation, sick days, holidays and personal time Adoption assistance To Learn More, Go To Our Benefits Summary. Not all benefits apply to all jobs The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer We need to remove boilerplate: Equal Opportunity Employer, legal statement sentences like "The above information..." maybe considered boilerplate? It's a generic disclaimer; but it's part of the posting. The instruction: "Remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions." So we should remove the disclaimer sentences: "The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job." Also "Equal Opportunity Employer". Also maybe "To Learn More, Go To Our Benefits Summary." is not boilerplate? It's a reference; but could be considered application instruction? It's not exactly instruction to apply; but it's a link to benefits summary. Might be okay to keep? The instruction says remove application instructions. This is not exactly application instruction but a reference. Might keep. However "Not all benefits apply to all jobs" is a qualifier; could keep. We'll keep benefits list but remove the fluff. Now produce HTML. Structure:

    About the role

    Remote opportunity! Experience with analyzing provider data and training on current billing guidelines to identify trends is a plus! Previous auditing experience of evaluation and management and surgical procedures is preferred! Working knowledge of EXCEL and MS Publisher.

    BJC Medical Group is the multi-specialty physician-led organization of BJC HealthCare and includes over 600 doctors and advanced practice providers who are affiliated with top-ranked hospitals in the Midwest region. Since 1994, BJC Medical Group has provided access to extraordinary care in over 145 locations and over 25 specialties in the greater St. Louis, mid-Missouri and southern Illinois areas. Our providers are nationally recognized for excellent patient satisfaction, quality health care, and improving the health and well-being of the communities we serve. The Quality and Compliance Department provides support to the strategic and operational objectives of BJC Medical Group practices is located in Town & Country, MO.

    The Senior Compliance Coordinator conducts and coordinates reviews of BJCMG specialty provider documentation to ensure accuracy of services billed. This position prepares reports of findings to be presented to providers. This position also develops educational opportunities for new and existing providers giving instruction on federal and state regulations, documentation guidelines, and coding training in a way that ensures compliance with governmental regulations. Additionally, the Senior Compliance Coordinator collaborates with departments in providing appropriate education to staff as it relates to compliance and privacy of protected health information.

    Responsibilities

    • Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services identified as part of the review for specialty providers or up on request from management.
    • Interacts with specialty providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation based on the review.
    • Develops and/or presents educational training material to specialty providers and coders based on findings and trends identified as a result of the reviews; provides general education on coding and documentation rules and regulations, regulatory provisions, and third party payer requirements to new employees and providers to include Employee and Provider New Employee Orientation.
    • Interacts with government agencies/contractors, management, employees and others, as necessary, to ensure an understanding of the organization’s compliance initiatives.
    • Conducts and coordinates routinely scheduled reviews of BJCMG specialty providers' documentation involved with professional fee billing for accuracy of coding and physical presence; reviews consist of ambulatory E&M services and office procedures, as well as hospital admissions, subsequent visits, hospital procedures, and all other services performed by BJCMG specialty providers; reviews medical record documentation to identify under-coded and up-coded services, prepares reports of findings, and meets with providers to provide education and training on accurate coding practices and compliance issues; serves as subject matter expert related to specialty coding.
    • Conducts focused reviews across the BJCMG enterprise based upon the Compliance Department's annual work plan and/or trends identified based upon internal reviews or requests from senior leadership; performs special projects as requested/assigned by management