**Description** Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work? Summary: + Position Summary: The Pro Fee Compliance Analyst is responsible for supporting the Penn Medicine Office of Billing Compliance and Review Services OBC by reviewing, promoting and evaluating professional coding and professional fee billing. This position is responsible for the performance of annual reviews of professional fee billing specifically for Penn Medicine providers. The Pro Fee Compliance Analyst is responsible for risk-based reviews of professional billing and coding practices as it relates to government payors. Pro-Fee Compliance Department Analyst works in accordance with the Penn Medicine Lancaster General Health Compliance Program and the OBC Billing Compliance Manual, the OBC New Prover Manaul and the OBC Annual Audit Process. The Pro-Fee Compliance Department Analyst serves as a role model for compliant and ethical behavior consist with the mission, vision and values of Penn Medicine and Penn Medicine LG Health. + Qualified individuals must have the ability with or without reasonable accommodation to perform the following duties: + Perform systematic reviews of professional fee billing and coding ensuring that documentation supports billed services. + Performs focused medical reviews in response to internal external allegations or as triggered by internal external benchmarking, and audit findings. + Identify patterns in denials working with appropriate parties to correct errors and mitigate future errors. + Monitors CMS federal regulations, local Medicare Administrative Contractor guidance, state rules, regulations, and trade publications. + Analyzes potential risk to the enterprise related to CMS rules, Medicare Administrative Contractor guidance, and industry news. + Researches topics with the capability to interpret complex rules and regulations. + Keeps abreast of CPT coding changes. + Demonstrates technical professional expertise and understanding related to elements of the compliance role. + Evaluates adherence to policies and procedures with respect to coding and billing. + Provides accurate guidance response congruent with standards of CMS, correct coding guidelines, National Correct Coding Initiatives from client inquiries. + Compiles and presents summary reports on findings from audits for Executive Management according to Office of Billing Compliance and Penn Medicine LG Health protocols that highlight deficiencies and recommend corrective actions. + Compiles and prepares materials for meetings as necessary; ensures accuracy of information provided. + Ability to educate providers as required from research and audit findings as needed. + Raise issues and concerns to the Penn Medicine LG Health Compliance Manager, designee or other appropriate resource to validate and re mediate problems. + Participate in external audits from the Center of Medicare and Medicaid Services CMS , Recovery Audit Contractors RAC and Medicare Administrative Contractor MAC , Office of Inspector General OIG and Department of Justice DOJ , as necessary. + The following duties are considered secondary to the primary duties listed above: + Coordinates interdepartmental and intradepartmental team approaches to review findings. + Performs other duties as assigned. Responsibilities: Minimum Required Qualifications: + Bachelor’s degree, preferably in healthcare related field such as Health Information Management, Health Administration, Nursing, OR proof of equivalent work related experience. + Must hold current coding certificate such as: CPC, Registered Health Information Administrator RHIA , Hospital Coding Certificate CCS , other coding certificates e.g. RHIT, CCS-P, CPC-H COC, CCS, CPMA , + Three 3 or more years of practical experience in health care regulation. + Extensive knowledge of various coding and reimbursement systems and coding experience. + Knowledge of rules and regulations pertaining to federally funded programs e.g. Medicare and Medicaid along with knowledge of documentation requirements for coding and billing. + Highly developed analytical and organizational skills; excellent written and verbal communication skills and the ability to articulate difficult concepts in an understandable manner. + Knowledge of Microsoft Word, Excel, Power Point and Outlook Preferred Qualifications: + Experience with electronic health records, preferably EPIC. + Extensive experience with coding software products. + Experience with technical writing report writing. We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives. Live Your Life's Work We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law. REQNUMBER: 256525