Healthcare Compliance Specialist
3 days ago
**About Us**
At Cooper University Health Care, our commitment to providing exceptional healthcare begins with our team of dedicated professionals. Our mission is to deliver outstanding patient care and achieve excellence in all that we do.
**Job Summary**
We are seeking an experienced Healthcare Compliance Specialist to join our team. The successful candidate will be responsible for coordinating external reviews and audits, including Medicare RAC, Medicaid RAC, and other third-party auditors. This includes establishing workflows, policies, and procedures to ensure timely completion of review/audit documentation requests.
**Key Responsibilities**
- Coordinate external reviews and audits, including Medicare RAC, Medicaid RAC, and other third-party auditors.
- Establish workflows, policies, and procedures to ensure timely completion of review/audit documentation requests.
- Analyze review/audit findings and denials to identify problems in processes.
- Prepare and submit basic payer appeals, including review and submission of supporting documentation and regulations.
**Requirements**
- Must have a clinical or patient accounting background with fundamental knowledge of the Revenue Cycle Process.
- In-depth familiarity with third-party billing requirements, governmental regulations, and billing documentation compliance requirements.
- Minimum of 1 year of experience coordinating the third-party audit review cycle.
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