Jobs
>
Plymouth

    Senior Compliance Monitoring Manager - Plymouth, Devon, United Kingdom - Ophthalmic Consultants of Boston, Inc

    Ophthalmic Consultants of Boston, Inc
    Ophthalmic Consultants of Boston, Inc Plymouth, Devon, United Kingdom

    6 days ago

    Default job background
    Description
    OCB is currently seeking a Healthcare Compliance Manager. They will be based out of our Plymouth office and travel to other offices as necessary.

    The ideal candidate will have prior clinical experience, successfully worked across all levels of an Ophthalmic, sub-specialty or general medical practice, with significant experience and exposure to compliance, billing, and coding practices.

    This "hands-on" role is responsible for designing, developing, implementing, supervising, and reviewing internal policies, procedures, processes, and practices to assure all patient coding and documentation is accurately interpreted, captured, and managed in accordance with regulatory and Practice requirements.

    Works across the practice and entities with providers, clinical managers, technicians, scribes, and billing personnel to educate, train, audit, research, investigate, problem solve and resolve compliance related requirements and issues; mitigating risks and reinforcing required practices to assure best practices are implemented and maintained throughout the Practice and its affiliates.

    Maintains an in-depth and ongoing understanding of industry related compliance requirements, issues, coding updates, regulatory changes, and industry related best practices.

    Assures OCB's Compliance Program is aligned with regulatory and Practice requirements by developing, implementing, monitoring, and maintaining policies, procedures, and programs to support ongoing activities and requirements of compliance program.

    Coordinates and delivers educational training programs consisting of appropriate documentation guidelines, and accurate coding to all appropriate personnel including coding staff, scribes, clinical managers and technicians, physicians/providers, and billing personnel.

    Perform internal audits and compliance reviews, identifying, escalating, resolving, and managing requirements and issues in timely and proactive manner.

    Conduct regular coding audits and coordinate the monitoring of coding and documentation accuracy, reviewing claim denials and rejections pertaining to coding and medical necessity issues.

    Proactively identifies less-apparent coding issues and red flags, by monitoring data, reporting, and procedures/practices to anticipate the obvious and most complex of coding issues; continuously mitigating risks by escalating as needed and recommending remedies.

    When necessary, assist in the implementation of corrective action plans, such as educational programs to prevent similar denials and rejections from recurring.

    Receive, investigate, and report on compliance complaints and "hotline" reports.
    Conduct annual audits as it relates to regulatory agencies assuring adherence to regulatory requirements.

    Report non-compliance issues detected through auditing and monitoring, create corrective action plans and results of follow-up audits to the VP of Operations and Senior Management.

    Maintain ongoing knowledge of coding, regulations, and compliance/regulatory agencies.
    Provide research and support for special projects.
    Minimum of five to seven years of physician billing/auditing experience. Extensive knowledge of CPT coding principles, guidelines and practices is required.
    Experience with performing physician compliance reviews of healthcare institutions especially subspecialties, ideally in an ophthalmic setting.
    Knowledge of electronic medical records and practice management software

    Minimum of 5 years of medical auditing in a health care setting, progressive experience in out-patient coding and billing preferred.

    Strong knowledge of Federal (HIPPA) and State health care regulations, standards, policies and requirements pertaining to documentation, coding and billing.

    The ability to accurately interpret and implement regulatory standards and legal requirements
    Strong analytical and problem-solving skills and proficient in report writing and oral communications
    Strong computer skills
    Bachelor's degree, or equivalent experience. Ability to travel to various offices
    Health & Dental Insurance- eligible 1st day of employment
    ~ Paid time off and paid holidays
    ~ Health & Dependent Reimbursement Accounts
    ~Company paid Life and LTD Insurance
    ~ Employee discounts

    To find out more about OCB, please visit our website at .
  • University Hospitals Plymouth NHS Trust

    Imaging Booking Team Leader

    4 days ago

    University Hospitals Plymouth NHS Trust Plymouth, United Kingdom

    To provide direct support to the Imaging Booking Team (IBT) Manager and teams in the appointed area within the IBT, ensuring strict compliance with Trust policies and procedures. · The key responsibility of this role is to work as part of a professional multi-skilled team within ...

  • University Hospitals Plymouth NHS Trust

    Team Leader

    1 week ago

    University Hospitals Plymouth NHS Trust Plymouth, United Kingdom

    We have an exciting opportunity to work within the Outpatient Appointment Centre as a Team Leader. You will manage a small team and work closely with Service Line Management teams to meet trust targets. You will work closely with the OAC Manager and attend regular meetings with a ...

  • Securewest International

    Global Response Operator

    1 week ago

    Securewest International Plymouth, United Kingdom

    Securewest is seeking a Global Response Operator to provide first line support and emergency response to our travel risk and maritime clients in accordance with pre-defined protocols and operational procedures. The role is desk-based utilising our risk management platform to moni ...

  • Livewell Southwest

    Referral Co-ordinator

    1 week ago

    Livewell Southwest Plymouth, United Kingdom

    The Referral Co-ordinator will be responsible for the triage and coordination of throughput through the Glenbourne Unit. This will include; triaging and redirecting calls, gathering thorough referral information so as to aid the nurse in charge in safe clinical decision making an ...

  • DK Recruitment

    Head of Supply Chain

    1 week ago

    DK Recruitment Plymouth, United Kingdom

    We are currently recruiting for an experienced Supply Chain Manager for a well-established Manufacturer in Plymouth. · The Head of Supply Chain will required to manage the businesses Supply Management and Inventory Management to ensure the continued growth and strategic performan ...

  • MLT Recruitment Services

    Compliance Team Leader

    1 week ago

    MLT Recruitment Services Plymouth, United Kingdom

    **_Duties & Responsibilities_** · The Compliance Technician is responsible for assisting with regulations & internal controls in accordance with our Quality, Safety & Environmental management systems, policies and Procedures (ISO 9001 Quality Management System, ISO 14001 Environm ...

  • Path

    Admin Assistant

    4 days ago

    Path Plymouth, United Kingdom

    **ROLE PROFILE** · **Administrative Assistant** · **Role Profile** · **Reports to** Office Manager **Hours ** 20pw · **Location** Harwell Centre **Shift Pattern** Office hours, with some flexibility to provide holiday cover · **CRB check required** - enhanced · Path is an indepen ...

  • NFP People

    Service Manager

    1 hour ago

    NFP People Plymouth, United Kingdom Full time

    Service Manager · Do you want to make a difference every day? Do you want to contribute to change and improvement for those who need it? Do you have resilience and adaptability? Can you work effectively with a focus on customer service and care? · We have an exciting opportunity ...

  • University Hospitals Plymouth NHS Trust

    Reception Team Leader

    2 days ago

    University Hospitals Plymouth NHS Trust Plymouth, United Kingdom

    The purpose of the post is to increase membership & improve attrition rates by providing high level customer service & care through the provision of a super-efficient & friendly reception/membership management service. · DCHW is a small department within UHPT. As a small dynamic ...

  • University Hospitals Plymouth NHS Trust

    Senior Systems Officer

    1 week ago

    University Hospitals Plymouth NHS Trust Plymouth, United Kingdom

    The Senior Systems Officer supports the delivery of an exemplar Occupational Health and Wellbeing service to employees of University Hospitals Plymouth NHS Trust and of external businesses through expertise in information management systems and processes. As a key member of the S ...

  • Mace

    Construction Support

    1 day ago

    Mace Plymouth, United Kingdom

    The opportunity · Project: Mace is seeking to appoint an experienced construction manager to plan, direct, manage and oversee implementation of construction projects to ensure the client goals and objectives are accomplished within prescribed schedule, budget and defined health, ...

  • Livewell Southwest

    Administrator

    1 week ago

    Livewell Southwest Plymouth, United Kingdom

    Arrange appointments, meetings and events on behalf of the service, making bookings where necessary and ensuring all equipment and documentation is available, in conjunction with line manager where required. To produce minutes as an accurate record of meetings, transcribing and d ...

  • Peregrine Risk Management

    Global Security Operations Officer

    4 days ago

    Peregrine Risk Management Plymouth, United Kingdom

    **Work location**: Office Based in Plymouth (there are no hybrid or remote working options for this position) · **Type**: Full Time (12 Hour Shift Patterns inclusive of 2 days, 2 nights followed by 4 days off) · This is a great opportunity to join a growing business in an excitin ...

  • University Hospitals Plymouth NHS Trust

    D&i Service Improvement Facilitator

    2 days ago

    University Hospitals Plymouth NHS Trust Plymouth, United Kingdom

    Support the Delivery of Improvement Initiatives Assist with the planning, delivery, and monitoring of several service improvement initiatives within the department. Plan and monitor the delivery of actions across the departments improvement initiatives. Plan and monitor the alloc ...

  • CASSPLUS

    Monitoring & Evaluation Officer

    2 days ago

    CASSPLUS Plymouth, United Kingdom

    **Are you an experienced monitoring & evaluation specialist?** · **Passionate about using your skills to make a difference?** · Our system does not always address the root causes of crime. Anyone can end up at court alone, feeling powerless, trapped and terrified. CASS+ is indepe ...

  • University Hospitals Plymouth NHS Trust

    Ultrasound Administrator

    4 days ago

    University Hospitals Plymouth NHS Trust Plymouth, United Kingdom

    To act as first point of contact in US department and receive, coordinate and communicate information for users within the US Department and Derriford Hospital. This will include staff reporting absences/sickness. The absences will be checked against the current ultrasound rota a ...

  • Livewell Southwest

    Administrative Supervisor/secretary

    1 week ago

    Livewell Southwest Plymouth, United Kingdom

    training logs using organisational systems as directed (ensuring ease of access/retrieval as appropriate) and in line with policies. Supporting operational staff to access management information; electronic and hard copy. Collect and collate data to enable managers to monitor bud ...

  • Livewell Southwest

    Referral Co-ordinator

    1 day ago

    Livewell Southwest Plymouth, United Kingdom

    Bed Bureau To support the Bed Bureau team managers with data and information required to enable the running of the service. To use a variety of IT systems to produce reports and data for analysis by the Bed Bureau team managers. To hold data base information to support the Bed Bu ...

  • Plymouth and South Devon Freeport Ltd

    Project Coordinator

    1 week ago

    Plymouth and South Devon Freeport Ltd Plymouth, United Kingdom

    **Project Coordinator** · **Reports to**: Chief Executive Officer · **Working arrangement**: Office based hot-desk/touch down worker · **Term**: Permanent post 6 month probation · **Salary range**: £35,000 - £37,500 · **Primary purpose of the role** · The Project Coordinator is r ...

  • Ministry of Defence

    Logistics Officer

    6 days ago

    Ministry of Defence Plymouth, United Kingdom

    **Details**: · **Reference number**: · **Salary**: · - £26,350- per annum**Job grade**: · - Executive Officer- Band D**Contract type**: · - Permanent**Business area**: · - MOD - Navy - Estates & Service Delivery Group**Type of role**: · - Logistics · - Operational Delivery**Worki ...