Senior Compliance Officer Administrative Director, Quality, Clinical Audit Billing Cycle

Western Connecticut Health Network - Connecticut - ., performing auditing and monitoring, drafting written policies and procedures, developing internal controls to reduce compliance risks) the following compliance risk areas: a) medical necessity; b) Quality of care; c) Medical record documentation; d) Credentialing; e) Employee health screening requirements; f) Coding; g) Billing; h) Claims submissions; i) Claims reimbursement; j) Payments; k) Human subject research; l) Centers for Medicare and Medicaid ('CMS') conditions of participation; m) Accountable... management and clinical audit experience in reviewing medical record documentation and billing. - Knowledge of hospital or other healthcare billing, coding and documentation guidelines and regulations. - Ability to understand and interpret State and Federal regulations related to hospital billing and documentation. - Knowledge of information systems, managed care, and revenue cycle. - Verbal and written communication skills. - Ability to analyze data and investigational findings and summarize the...
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