Job Description

Job Details Job Location Cantex Corporate - Carrollton, TX Position Type Full Time Job Category Compliance Description Summary: The Revenue Compliance Analyst ensures accurate documentation, coding, and billing practices at Cantex. This role supports the Revenue Compliance and Reimbursement teams in safeguarding revenue and maintaining regulatory compliance. Qualifications Key Responsibilities: Review clinical documentation for accuracy and completeness in accordance with CMS and OIG regulations. Audit claims for correct diagnosis and CPT coding, billing accuracy, and timely submission. Identify trends in denials or billing errors and recommend corrective actions. Collaborate with the Compliance Department on internal audits. Support training efforts for clinical and billing staff on documentation standards. Complete and review Additional Documentation Requests (ADRs), Appeals, Quality of Care (QOC) and Risk Analysis (RA) from Managed Care and Medicare entities. Provide information or feedback/ recommendations. Demonstrate professionalism in communication to various departments and outside entities. Monitor the effectuations of all resolution / outcomes related to the above pertaining to ADRs, Appeals, QOC and RA. Complete audits in various areas according to rules and regulations and offer positive or constructive feedback. Manage government probes, including educating on the process, and develop corrective action plans as needed. Regulatory research by performing comprehensive research related to payer guidance, facts and circumstances impacting payment outcomes. Communicate as a revenue liaison with payers, providers and billing. Be able to travel periodically to various facilities and sites Able to work on computer and use technology to complete work. Qualifications: Nurse or Therapist for minimum of 5 years who has worked in or familiar in the areas of SNF, Home Health, Hospice Must have coding certification or certifications that assist with auditing. We are an Equal opportunity employer; We offer an excellent benefit plan to include 401K with match, CEU reimbursement, vacation, sick, holidays, medical, dental, and supplemental insurance Plans as well as a Highly competitive compensation package. Diversity, Equity and Inclusion are at the heart of Pivot Rehab. We are committed to a culture that respects our differences and values the contribution of all people. #Corp Cantex Continuing Care Network

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