Summary: Testing Compliance Coordinator will support the coordination of participant related health testing by monitoring and administrating the compliance database, workflow, health records, and for assigned billing code review. This position will work directly with Compliance and Risk Manager and support the Federally Qualified Health Center (FQHC) with expectations to be collaborative with health center management, providers, and revenue cycle management related to compliance auditing and processes.
Essential Duties and Responsibilities:
- Ensure the company reporting of consent to test and release information is being monitored per the assigned timelines.
- Medical record compilation and retention (for participants that are HAH non-affiliated)
- Ensure HAH’s reporting responsibilities to all external agencies such as Chicago Public Health Department, HRSA, or as assigned.
- Oversees all participant positive test reports by working in the EMR and RMIS database to ensure compliance with internal policy.
- Manage data collection process to include tracking individual test results and PII as assigned by the operational procedures for funders and granters.
- Assisting the Health Center medical records personnel in uploading and reviewing of the testing results as outlined in the standard operating procedure.
- Ensure compliance of adherence to grants, billing practices, and coding of service by completing assigned audits per assigned schedules.
Revenue Cycle Program Auditing For Test Funding
- Ensure coverage verification for testing is accurately coded (per policy type and plan)
- Manage and reconcile tracking reports with billing submission and payments for assigned accounts or codes.
- Ensure compliance auditing by completing the tracking log for billing data related to assigned billing claims and escalate to appropriate manager if a bill is non-compliant.
- Participate in assigned meetings.
- Other duties as assigned that relate to this role’s scope and ensure HAH meets their mission and strategic goals.
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Education and/or Experience: High school diploma/GED and a medical billing and coding certification plus one year of experience in a medical billing and coding role preferable in community health.
- Travel and Driving Requirements: Will be required to travel up to 50% of workweek to three other sites in the Chicagoland area as scheduled so reliable transportation is required.
- Other Qualifications: Strong working knowledge of Health Insurance Portability and Accountability Act (HIPAA), Personal Health Information (PHI), Personal Identifiable Information (PII), Electronic Medical Records (EMR), databases, and medical record documentation.
- Computer Qualifications : Demonstrated computer proficiency, including knowledge of word processing and spreadsheet software.
- Language Skills: Fluency in a second language is beneficial. Excellent written and verbal communication skills, including phone etiquette. Ability to read and interpret documents. Ability to write routine correspondence.
- Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
- Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
- Multi-tasking: Ability to multi-task and stay organized in a fast-paced environment.
- A criminal background check and immunization records are required for employees working for Heartland Alliance Health.
Competencies: To perform the job successfully, an individual should demonstrate the following competencies.
- Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in-group problem solving situations; Uses reason even when dealing with emotional topics.
- Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.
- Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
- Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
- Judgment - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
- Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Plans for additional resources; Sets goals and objectives; Organizes or schedules other people and their tasks; Develops realistic action plans.
- Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
- Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
- Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel and talk or hear.
- The employee is frequently required to reach with hands and arms.
- The employee is occasionally required to stand; walk; sit; climb or balance; and stoop, kneel, crouch, or crawl.
- The employee must occasionally lift and/or move up to 15 pounds.
Heartland Alliance makes all hiring and employment decisions, and operates all programs, services, and functions without regard to race, receipt of an order of protection, creed, color, age, gender, gender identity, marital or parental status, religion, ancestry, national origin, amnesty, physical or mental disability, protected veterans status, genetic information, sexual orientation, immigrant status, political affiliation or belief, use of FMLA, VESSA, military, and family military rights, ex-offender status (depending on the offense and position to be filled), unfavorable military discharge, membership in an organization whose primary purpose is the protection of civil rights or improvement of living conditions and human relations, height, weight, or HIV infection, in accord with the organization's AIDS Policy Statement of September 1987.I,A3303_837_0