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Johns Hopkins Medicine · 3 weeks ago

Billing Compliance Program Manager

DC-Baltimore Area

Full-time

Onsite

Senior Level

$40.39/hr - $64.63/hr

5+ years exp

Johns Hopkins Medicine is a renowned health system, and they are seeking a Billing Compliance Program Manager. This role is responsible for the development, implementation, and monitoring of the Corporate Compliance Program, focusing on federal payor billing compliance and providing compliance guidance to personnel within the organization.

Health CareHealth DiagnosticsHospitalMedicalTraining

Responsibilities

Responsible for the development, implementation, and ongoing monitoring of the Corporate Compliance Program with a particular emphasis on federal payor billing compliance and compliance related education for the Johns Hopkins Health System Corporation and its affiliates

Independently assessing a variety of complex compliance risk-areas within the JHHS affiliates to develop the Compliance Department’s work plan

Independently performing scheduled audits required by the work plan, unplanned investigations and in carrying out these activities independently providing compliance guidance to JHHS personnel

Using judgment and critical thinking skills in determining appropriate corrective action for non-compliance as well as ensures that corrective action is taken by the affiliate

Monitoring and responding to certain regulatory requests and representing the Compliance Department on various committees as requested

Providing regular guidance and advice to JHHS personnel, leadership and Executive Management in compliance related areas

Conducting independent research in the areas of Medicare and Medicaid and other complex legal authorities pertaining to billing and regulatory compliance

Developing education and training for management and staff regarding federal payor regulatory requirements and other compliance matters based on the incumbent’s independent judgment of the affiliate’s educational needs

Managing audits conducted by vendors and payers and provide regular status reports to senior management

Reviewing the draft work product of their peers and to mentor and assist in the training and development of the compliance staff

Qualification

Billing complianceAuditingRegulatory complianceHealth care experienceTrainingDevelopmentCritical thinkingCommunication skills

Required

Requires a minimum of a Bachelor's degree

Requires a minimum of five (5) years' experience in health care (clinical or otherwise), coding, auditing, utilization management or related experience