Compliance Manager

Established in 1957,YAI empowers people with disabilities to reach their goals every day. Whether it’s navigating the New York subway alone, going to a Broadway show, or simply washing the dishes in their residence, our employees help over 20,000 people feel successful on their own terms. Our passionate staff of 4,000 professionals believes that everyone has a fundamental right to live, love, work and learn. If you share our vision and want to help support people to live the fullest lives possible, YAI will be the right place for you.

The Compliance Manager position’s time will be split between general Compliance responsibilities across the agencies of the YAI Network and the performance of documentation reviews of services provided in the medical clinics of YAI and PHC. The ideal candidate will hold a current outpatient coding credential (CCS-P or CHC) granted by either the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC). Outpatient coder assures accurate coding and documentation of outpatient services in support of appropriate reimbursement and the gathering of other health care statistics. Interprets and classifies diagnosis and procedures documented in the medical record into coded (numeric) values.

Duties and Responsibilities:

• Evaluate the assignment of outpatient medical diagnosis and procedure codes. (ICD-10-CM, CPT, HCPCS).
• Knowledge of state and federal regulations as they relate to the documentation and billing of services provided.
• Develop written policies and procedures.
• Effectively present information and respond to questions both from internal and external sources
• Analyze and interpret government standards, laws and regulations.
• Assist with General Compliance Training, documentation, communications and implementation as needed.
• Maintain coding currency, be updated on changes.
• Develop and update compliance training materials.
• Works in collaboration with other departments.
• Perform general Compliance audits as needed.
• Produce written reports of audits conducted.

Requirements:

• 3 years experience in Compliance preferred.
• Credentialed as a professional outpatient coder:

CPC Credential from AAPC

CCS-P Credential from AHIMA

• Knowledge of ICD-10-CM diagnosis codes.
• Knowledge of CPT and HCPCS procedure and Evaluation and Management codes.
• BA or BS degree.
• 2 years experience in Evaluation and Management coding reviews.
• 1 year experience in Provider Training in the appropriate assignment of ICD-10-CM and CPT codes.
• 1-2 years Project Management experience, Provider Initiatives preferred (e.g., PCMH, MU, MACRA, etc.).
• Knowledge of HIPAA a plus.
• 1 year ID/DD or related social service experience preferred.
• Excellent written and verbal communication skills.
• Strong commitment and passion for the organization’s mission.
• Unquestionable ethics and integrity and high emotional intelligence.
• Complete ability to maintain the confidentially and security of sensitive information and files.
• Functional and technical skills.
• Great ability to be customer focused, when required.
• Strong public speaking abilities.
• Knowledge of OPWDD and YAI’s rules and regulations a plus.
• Great use of time management.
• Willingness and ability to travel to the varied neighborhoods of New York City that YAI services.

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled