Billing Compliance Specialist – Audit & Compliance
Maine Medical Center
Full Time, Days
Maine Medical Center is seeking a Billing Compliance Specialist in Portland. This position is responsible for review and analysis of documentation to support acceptable billing and documentation practices at Maine Medical Center and will also be available for MaineHealth and its subsidiaries. The Billing Compliance Specialist prepares logs and statistical reports of findings and appropriately disseminates information to the Department or Program Chief, Medical Record Services, Patient Accounts and others. The findings and analyses are used to evaluate compliance with various billing regulations. Technical and educational assistance is provided to various staff on improving documentation in relation to meeting compliance with billing regulations. Auditing and educational assistance are provided to various departments as necessary.
- Possess one of the following certifications: AHIMA-RHIT, CCS, CCS-P; AAPC-CPC, CPC-H, CPMA; HCCA-CHC and/or clinical experience as an RN or LPN with the expectation of earning a certification within one year.
- Five years’ experience with broad knowledge of medical terminology, anatomy and physiology, pathophysiology and disease process.
- In depth knowledge of hospital organizations and medical practices.
- Knowledge of physician billing practices, CMS billing regulations, CPT coding guidelines from the American Medical Association.
- Ability to establish and maintain effective working relationships with physicians, subordinates, administrators, supervisors, outside agency personnel, and all levels of hospital personnel in relation to appropriate documentation practices and compliance.
- Ability to direct the processing, collection, maintenance and analysis of compiled information and the preparation of reports from this data.
- Ability to maintain confidentiality in the performance of duties.
- Ability to analyze data and interpret it to others.
- Ability to maintain the stamina required to perform detailed and repetitive reviews and audits on a continuous basis.
- Ability to work independently and self-directed.
About Maine Medical Center:
Maine Medical Center is a complete healthcare resource for the people of greater Portland, the entire state of Maine and Northern New England. With a history dating back to 1864, Maine Medical Center is the state’s largest medical center and the flagship facility of MaineHealth, with 637 beds and more than 7,000 employees. In addition, we have achieved Magnet™ status in recognition of our commitment to the highest standards of nursing excellence. Maine Medical Center’s unique role as both a community hospital and a referral center requires an unparalleled depth and breadth of services, including the state’s only medical school, through a partnership with Tufts University School of Medicine, and a world-class biomedical research center, the Maine Medical Center Research Institute.
Inside and out, you’ll find what you’re looking for when you join Maine Medical Center. As the largest hospital in northern New England, MMC is committed to helping you grow professionally throughout your career. From tuition assistance and scholarships, to ongoing education, leadership training, mentoring and promotion opportunities, we offer the resources you need to achieve your career goals.
MaineHealth values diversity and is an Equal Opportunity/Affirmative Action employer. Federal and state laws prohibit discrimination in employment because of race, color, national origin, religion, age, sex, sexual orientation, disability or veteran status.