Senior Compliance Specialist (CPC Certification) New York, NY - NYU Langone : Job Details

Senior Compliance Specialist (CPC Certification) New York, NY

NYU Langone

Job Location : New York,NY, USA

Posted on : 2025-08-05T09:06:14Z

Job Description :

Senior Compliance Specialist (CPC Certification) Position Summary:We have an exciting opportunity to join our team as a Senior Compliance Specialist.In this role, the Senior Compliance Specialist will assist the Manager of Professional Billing Compliance in conducting inpatient and outpatient coding, billing and medical record documentation reviews in accordance with Federal, state and local regulations. Responsibilities include drafting written reports on audit findings and providing in-service training to physicians and staffJob Responsibilities:Responsible for conducting audits of medical records to determine whether services provided to patients are appropriately documented and billed in accordance with Medicare, Medicaid and third party billing regulations and/or standardsDrafts written reports that summarize medical record review findings for Manager reviewPerforms assessments of new physicians to NYU Langone and provides education based on the results of the assessment. Follow-up provided as appropriate.Assists Manager in investigating inquires which may relate to erroneous billing and coding of servicesPerforms reviews of Medicare Pre Probe audits and provides recommendations regarding the results to FGP managementDevelops relationships with FGP Practice Managers, FGP departmental administrators, operations managers, etc. to ensure open communication between the Compliance department and the physician practicesWorks closely with the physicians and FGP practices in order to educate them as to improvements in billing and documentation practicesProvides in-services/presentations to physicians and staff post audit, to various practices per request, and as neededPerforms billing and/or coding research for inquiries utilizing various sources such as the Internet, Federal Register, Medicare Carriers Manual, CPT-4 and ICD-10 references, CPT Assistance, and other industry appropriate resourcesKeeps abreast of ICD-10, CPT-4, HCPCS, and CDT coding changes, compliance issues and regulations and provides communication and updates regarding changes in regulations, policies or procedures pertaining to the Compliance ProgramAssists Manager with compliance training initiatives including coordinating training classes, writing and editing compliance manuals, developing PowerPoint presentations, etc.Performs and participates in other related duties as requiredMinimum Qualifications:To qualify you must have a Bachelors degree in Finance, Healthcare administration or related field.Minimum of 4 years of professional coding and billing experience.Certification in clinical coding is required.Strong problem solving and analytical skills.Excellent verbal and written communication skills.Proficiency in Microsoft office.Must be able to communicate with physicians, senior administrators and office staff.Epic systems and/or EHR experience.Preferred Qualifications:Master's DegreeMDAudit Enterprise experienceCertification in dental codingQualified candidates must be able to effectively communicate with all levels of the organization.NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.If you wish to view NYU Langone Health's EEO policies, please click here . Please click here to view the Federal EEO is the law poster or visit for more information.NYU Langone Health provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $81,325.15 - $135,541.73 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.To view the Pay Transparency Notice, please click here#J-18808-Ljbffr

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