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Senior Coding Compliance Specialist, ACO - REMOTE
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Full-time
Remote
- POSITION SUMMARYUnder the direction of the Chief Compliance & Privacy Officer and the Director of Compliance & Audit, the ACO Compliance Specialist will coordinate and support compliance functions and activities in support of enabling Sound Long-Term Care Management Accountable Care Organization (SLTCM-ACO) providers to comply with all applicable billing and privacy compliance regulations.
- Through the review process, the ACO Compliance Specialist also identifies opportunities to improve coding practices and related business processes or issues needing further review, assessment, and follow-up.
- The ACO Compliance Specialist will maintain current knowledge of applicable laws and regulations and may contribute to the unit’s risk assessments and risk mitigation strategies.
- ESSENTIAL DUTIES AND RESPONSIBILITIES Perform complex coding and documentation compliance reviews of SLTCM-ACO partners in the Nursing Facility, Post-Acute Care, and Telemedicine settings using applicable rules, regulations, and coding conventions for billing to determine the accuracy of coded and billed services, including APP services where applicable.
- Report and review audit findings with Chief Medical Officer, Value Based Care for SLTCM-ACO and the Chief Compliance & Privacy Officer on a regular basis to identify trends, issues, and potential risk areas.
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