LifePoint Health has an Remote opportunity for Manager, Compliance Monitoring and Regulatory Support, in office, in Brentwood, TN. Under the general supervision of the Director of Compliance Monitoring and Regulatory Support for Physician Services, the Manager of CMRS provides regulatory support and oversight of compliance, coding compliance and monitoring functions

LifePoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.

ESSENTIAL FUNCTIONS: To perform this job, an individual must perform each essential function satisfactorily with or without reasonable accommodation.

• The Manager shall conduct audits for risk-based work plan items and performs validation of the results of ongoing monitoring to measure business operations output to outcomes.
• The Manager shall perform medical record reviews and compare services provided in the EMR and billing records to determine the accuracy and identify under and over-coded services.
• The Manager shall perform quality reviews of medical records to validate the integrity of ICD-10-CM diagnoses and CPT procedural codes.
• The Manager shall remain abreast of regulatory and procedure changes which may affect coding compliance and/or reimbursement.
• The Manager shall provide compliance regulatory research and analysis to guide operators and support the implementation of revised processes, controls, and risk mitigation strategies.
• The Manager shall support the business in developing appropriate internal controls, policies, and procedures to comply with regulatory requirements,
• Develop monitoring tools for the business, including compliance KPI, protocols, etc., including training materials
• The Manager shall have excellent oral and written communication, presentation, writing, and project management skills.
• The Manager shall maintain confidentiality and discretion regarding all work matters and fully comply with all legal and ethical obligations, the Company Code of Conduct, and the Code of Ethics for Healthcare Professionals adopted by the Health Care Compliance Association.
• Perform other duties as assigned

Education: Bachelor's Degree

Experience: 5+ years’ experience in compliance or a related area; detailed understanding of compliance and health care compliance risk areas related to functional area; understanding of business operations, objectives and challenges. Understanding and/or experience in physician services coding/auditing, ICD-10 diagnosis and CPT procedure coding and/or auditing.

Certifications: Registered Health Information Administration (RHIA), Certified Coding Specialist (CCS), Certified in Healthcare Compliance (CHC) or Certified in Healthcare Privacy Compliance (CHPC)

Moderate overnight travel (up to 25%) by land and/or air