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Hospital Coding & Compliance Specialist
Company Craneware Inc
Speciality Data Operations
Category Permanent
Location Country
Office LocationHome based – US
Additional Locations
Introduction to Craneware
Let’s transform the business of healthcare! At The Craneware Group, we are dedicated to empowering our customers with industry-defining insights that pave the way for a brighter future.
If you are an energetic, forward-thinking inidual with a passion for innovation, we invite you to join our thriving team of more than 750 dedicated professionals. Together, we’ll fuel the expansion of our SaaS platform and develop cutting-edge applications that redefine the healthcare landscape.
The Team
In this role you will be responsible for the maintenance and quality analysis of hospital-focused regulatory data used within Craneware products along with providing customer facing support & education.
You Will Be
- Research, interpret & update facility billing and compliance logic which is of a complex nature through the use internal tools or software products such that Craneware products and services are up to date and accurate.
- Work with other Data Revenue Advisors and Director of Revenue Data Advisory to define new and current logic for products and analysis.
- Acquire, receive, and track receipt of multiple data files from CMS, the AMA, and other regulatory bodies to determine its use within internal tools and software products, to ensure the products and services provided to customers are up to date and accurate.
- Manage customer expectations and service level agreements/timelines, ensuring that customers are kept up to date on all coding, billing, and compliance regulations.
- Maintain all departmental processes and procedures to detail the functions and data requirements of the products and company, to ensure accurate recording of processes and procedures.
- Continuously monitor facility-based billing technical, industry and business trends and take responsibility for personal development, to ensure that the future needs of the company are met.
- Perform QA for Revenue Data Analyst and other Revenue Data Advisory. Track and report productivity and QA of team.
- Work on complex QA projects.
- Provide customer facing support and responses to facility-based billing queries.
- Provide market facing educational sessions on complex regulatory material as required.
- Present at industry events (e.g. Summit, ANI, HFMA).
You Will Bring
- Educated to Bachelor‘s degree level
- 10+ years’ experience working in a hospital-based healthcare related field specific to revenue cycle, coding and/or reimbursement
- Deep knowledge of Medicare OPPS and IPPS coding & reimbursement methodologies
- Coding Certification or 15 years in a specific areas of regulatory data
- Broad knowledge in multiple area of healthcare regulatory arena– Reimbursement, OPPS, IPPS, ASC, Physician, etc.
- Microsoft Office – ability at intermediate level
- Intermediate Level of Project management skills
- High Level of communication skills both written and verbal
- Ability to self-plan and self-organize effectively and use appropriate tools for planning purposes
- Proven track record of accuracy and thoroughness
- Deep product knowledge of any specific Craneware products that are supported as well as general knowledge of any secondary product where data overlaps.
- Intermediate experience with Public Speaking