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Title

Senior Director of Compliance (Remote) 

EOE Statement eCatalyst Healthcare Solutions, Inc. is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.  
Description

Senior Director of Compliance (Remote)

Compensation: Depending on experience, certifications, and skillset.

Location: Phoenix, AZ, but will consider remote for the right candidate.

Status: Salaried, Exempt 

Job Summary

The Senior Director of Compliance is responsible for the overall compliance of eCatalyst, including HIPAA/HITECH, coding, auditing, and various health information management, and revenue cycle services.

The essential functions and key responsibilities include updating and implementation of the Privacy and Security Policy, coding and auditing policies, achieving strategic goals, and meeting or exceeding key performance indicators (KPIs), providing daily management and resource allocation of the internal and external auditing function, developing and delivery of internal and external education, developing and delivery of competency testing for employees and job seekers, ensuring staff have the technical skills to deliver services that meet quality and productivity standards, utilizing and optimizing auditing and learning management systems, and serving eCatalyst clients with unrelenting client focus.

Essential Functions

 Privacy & Security Officer

  • Lead the Privacy and Security team.
  • In conjunction with technical staff, maintain and update eCatalyst’s Privacy and Security Policy, conduct annual privacy and security risk assessment, and develop remediation plans based on risk assessment results and ensure remediation activities are completed per the established timelines.
  • Develop and distribute HIPAA training and ensure all eCatalyst employees complete required training on an ongoing basis.
  • Analyze business operations to ensure the most secure technical environments possible to reduce risk.
  • Review client’s Business Associate Agreements and identify potential risks.
  • Analyze and assess company’s activities for potential privacy and compliance risks and complete client IT assessments.

 

 Internal Quality Control

  • Meet or exceed the company’s goals and KPIs for coding and auditing quality, for both eCatalyst staff and offshore partners.
  • Develop and maintain eCatalyst’s coding and auditing policies, procedures, and guidelines.
  • Work with the Senior Directors of Coding and CDI to establish an audit profile for each client.
  • Maintain current documentation regarding the client’s auditing program, including focus areas.
  • Work with the Director of Human Resources to hire, manage, and provide corrective action for auditing staff when necessary. Hire and assign coding auditors based on need, credentials, and experience.
  • Ensure auditing is performed regularly as outlined in eCatalyst’s auditing policy and the client’s auditing profile.
  • Develop and compile auditing reports, analyze results, and distribute as instructed.
  • Provide specific audit result feedback to coders regarding audit results, including instructional aids, checklists, and resources.
  • Prepare client’s Quarterly Business Review slides regarding coding and auditing quality and productivity.
  • Audit the quality of the work performed by medical coders and auditors to ensure adherence to client and company standards.

 

 External Auditing

  • Participate in sales meetings as a coding and auditing subject matter expert (SME), as requested.
  • Meet with clients to develop an audit profile, document the profile, and communicate expectations with the team.
  • Assign auditors to external auditing projects based on credentials, experience, and availability.
  • Set up coding audits within the audit tool to maximize quality and efficiency.
  • Audit assigned auditors to ensure quality standards and KPIs are consistently achieved.
  • Review and respond to rebuttals to ensure quality and adherence to standards.
  • Produce audit summaries and review audit detail reports before submitting them to clients.
  • Participate on client audit report-out meetings as the audit leader and SME.

 

Education and Training

  • Identify training needs based on audit results, coding and regulatory changes, and new technologies.
  • Research updated coding information, rules, laws, and statutes for all payers and government entities.
  • In conjunction with the Senior Directors of Coding and CDI, develop an annual training calendar for coders and auditors.
  • Coordinate the update for all internal assessments (new hire and new position).
  • Develop and maintain pre-hire and pre-assignment assessments to assure high-quality coders and auditors are in place.
  • Prepare training for annual and targeted training (as a result of ongoing staff audits) including PowerPoint slides, coding and auditing instructions, tip sheets, and other educational resources.
  • Deliver effective individual and group training to improve the coding and auditing skills of the team.
  • Develop and maintain coding and auditing coursework in the learning management system (LMS) to assure currency of instruction.

 

Supervisory Responsibilities

  • Responsible for the management, day-to-day operations, and auditing team's performance.
  • Identify staffing resources, skill levels, certifications, and experience required to achieve client goals, SLAs, and KPIs successfully.
  • Work with Human Resources to identify the best-fit employees for specific assignments.
  • Establish work schedules and ensure resources are available to meet client demand.
  • Monitor productivity daily and work with staff to meet or exceed standards.
  • Work with the Senior Directors of Coding and CDI and Coding Managers to monitor and improve coding quality to meet or exceed SLAs and KPIs.
  • Review and approve timecards per established guidelines.
  • Communicate performance expectations to staff and routinely provide performance feedback, including 1:1 meetings and formal evaluations.

 

 Thought Leadership

  • Maintain current expert knowledge regarding coding guidelines, payer policies, OIG work-plans, and industry trends.
  • Maintain current knowledge of HIPAA, HITECH and other laws and regulations regarding protected health information.
  • Maintain an awareness of the current security and privacy threats facing eCatalyst and our clients.
  • Develop and deliver presentations on coding and auditing best practices, industry change, reimbursement/payors, and operational improvements to clients, trade show attendees, and industry groups.
 
Position Requirements

Required Certifications

  • CCS, CCS-P, or CPC certification. 
  • Bachelor’s Degree in Health Information Management (HIM) or related field. 
  • 8+ years of medical coding experience.
  • 5+ years of medical coding auditing experience with demonstrated background in hospital, physician, or other healthcare environment coding and reimbursement. 
  • Knowledge and understanding of HIPAA/HITECH and medical coding compliance.
  • Proficiency with ReviewMate Auditing Software.
  • Previous experience leading HIM operations, medical coding, or auditing teams.
  • Proficiency in Electronic Medical Records (EMR) such as EPIC and similar coding software systems. 
  • Demonstrated experience developing and maintaining client relationships.
  • Microsoft Office (Excel, Word, Outlook, Teams) proficiency.
  • Advanced verbal, nonverbal, visual, and written communication skills.

 

Preferred Education and Experience

  • CCS, CCS-P, or RHIA certification. 
  • Master’s degree with an emphasis in Health Information Management (HIM).
  • Experience working as a compliance officer.
  • Thorough understanding of HIPAA/HITECH and coding compliance.
  • Excellent technical skills, including experience with the industry’s leading encoders and EMRs.
  • Refined Microsoft Office (Excel, Word, PowerPoint, Teams) technical skills.
  • Proficiency with Learning Management Systems (LMS).

 

EEO Statement

It is the policy of eCatalyst Healthcare Solutions, Inc. to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. This policy relates to all phases of employment, including, but not limited to, recruiting, employment, placement, promotion, transfer, demotion, reduction of workforce and termination, rates of pay or other forms of compensation, selection for training, the use of all facilities, and participation in all company-sponsored employee activities. 

Please note this description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required for this job. Duties, responsibilities and activities may change at any time with or without notice. 

 
Full-Time/Part-Time Full-Time  
About the Organization eCatalyst Healthcare Solutions is proud to be one of the nation's top HIM and Middle Revenue Cycle companies. Our expertise includes coding, auditing, clinical documentation improvement (CDI), master patient index, registry, revenue cycle, staffing, consulting, and more. eCatalyst is distinguished by our highly experienced and credentialed team and our unrelenting client focus.  

This position is currently not accepting applications.

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