Compliance Manager

Job Description Summary

Entity

University Medical Associates (UMA) Only Employees and Financials

Worker Type

Employee

Worker Sub-Type​

Regular

Cost Center

CC002046 UMA CORP COMP Compliance CC

Pay Rate Type

Salary

Pay Grade

Health-27

Scheduled Weekly Hours

40

Work Shift

Day (United States of America)

Job Description

Job Family: MUSC Physicians/MUSC Physicians – Primary Care

Job Code:  

Job Title: Compliance Manager 1

Job Purpose: Manages professional coding and billing compliance operations for assigned specialties, providers, and care team members in accordance with the MUSC Physicians Compliance Plan and contracted entities supported by MUSC Physicians Compliance. Provides education to physicians, providers, and staff, and serves as a subject matter resource to assigned departments on coding, billing, and regulatory requirements. * This position is not remote; candidate must live within the Tri-County area. *

Education & Experience: High school diploma or equivalent required with a minimum of 2 years of experience in billing, coding, or compliance. Associate or bachelor’s degree preferred. Demonstrated technical proficiency with a strong understanding of business principles, regulatory requirements, and auditing processes. Working knowledge of ICD-10, CPT, HCPCS coding, and medical terminology required. Excellent written and verbal communication skills, with strong interpersonal abilities. Must exercise sound judgment in advancing compliance initiatives in alignment with MUSCP Compliance Department and organizational policies and procedures. Proficiency in Microsoft Office applications, including Word, Excel, and PowerPoint, required. Experience researching and responding to coding inquiries and/or educating professional billing providers is preferred.

Licensures, Registrations, Certifications: CPC, CCS-P, RHIA, RHIT or other medical coding certification preferred.

Physical Requirements: Continuous requirements are to perform job functions while standing, walking and sitting. Ability to bend at the waist, kneel, climb stairs, reach in all directions, fully use both hands and legs, possess good finger dexterity, perform repetitive motions with hands/wrists/elbows and shoulders, reach in all directions. Maintain 20/40 vision corrected, see and recognize objects close at hand and at a distance, work in a latex safe environment and work indoors. Frequently lift and/or carry objects close at hand and at a distance, work in a latex safe environment and work indoors. Frequently lift and/or carry objects weighing 20 lbs. (+/-) unassisted. Lift from 36” to overhead 15 lbs. Infrequently work in dusty areas and confined/cramped spaces.

 

Job Duties:

• (45%) Auditing

Complete assigned monthly audits in accordance with all MUSCP Compliance procedures, prioritizing audits as directed; report findings to the audited individual, Physician Liaison, Department Administrator, Chairman, and other designated leaders, while also monitoring, prioritizing, and maintaining active and deferred charges within the work queue in compliance with departmental guidelines.

 

• (35%) Compliance Advisory & Support Services

Provide comprehensive compliance support to the assigned specialty by serving as the primary compliance contact; attending meetings; delivering billing and regulatory education; researching coding and compliance issues; addressing concerns or allegations; collaborating with leadership to develop and implement corrective action plans in alignment with departmental procedures and the compliance plan; maintaining open communication with clinical, administrative, and leadership teams; monitoring regulatory and industry updates and communicating changes; and partnering with clinicians and EMR staff to support appropriate documentation standards and EHR template optimization.

 

• (10%) Internal Support- Compliance Plan Execution

Assist with Compliance Department responsibilities as outlined in the MUSCP Compliance Plan, including but not limited to supporting departmental compliance activities, policy and procedure review, risk assessment participation, audit evaluation and process improvement, preparation of annual compliance reporting materials, and other related duties as assigned.

 

• (10%) Competencies

Must consistently demonstrate and maintain the professional competencies and soft skills required for advancement within the career ladder, including effective communication, collaboration, critical thinking, sound judgment, accountability, adaptability, and a commitment to professionalism and continuous development.

Additional Job Description

Education:  High School Diploma or equivalent required
Experience:  Minimum of 2 years’ experience in billing, coding, and/or compliance required
Licensure/Certification: Current CPC, CCS-P, RHIA, RHIT or other medical coding certification preferred.

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

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