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MIPS Specialist (Radiology & Emergency Coding)

Ventra Health
  • US
    New York, New York, United States
  • US
    New York, New York, United States

Über

Regulatory Affairs Specialist The Regulatory Affairs Specialist provides cross-specialty administrative, compliance, and quality reporting support for Radiology, Anesthesia, Emergency Medicine, Hospital Medicine, and additional service lines as assigned. Reporting to the Healthcare Quality Director, this role assists in organizing, auditing, and maintaining the company's regulatory and quality programs—ensuring accuracy, compliance, and readiness for internal and external review. The Regulatory Affairs Specialist plays a key role in auditing documentation and coding, preparing regulatory materials, updating internal resources, and supporting the operational execution of quality programs such as MIPS (Merit-Based Incentive Payment System). This position collaborates closely with Operations, Coding, and Business Intelligence. A current Certified Professional Coder (CPC) credential and three years of experience with the MIPS program is required. Administrative & Program Support (Primary Responsibility)
Provides administrative and operational support for regulatory and quality programs across all supported specialties. Assists in maintaining program timelines, project plans, task lists, and internal tracking tools (e.g., Smartsheets). Helps prepare specialty-specific materials, workflows, and documentation for internal teams and clients. Supports the creation and maintenance of Standard Operating Procedures (SOPs), reference guides, and educational materials.
Auditing & Compliance Support
Conducts documentation, coding, and data audits under the direction of senior regulatory staff. Validates data used for MIPS and other quality programs to ensure accuracy and compliance. Assists with preparing, collecting, and organizing documentation for internal quality reviews or external audits. Identifies potential errors, inconsistencies, or compliance risks and appropriately escalates findings.
MIPS & Quality Reporting Support
Assists with MIPS data validation, workflow documentation, reporting preparation, and annual submission tasks. Supports cross-functional collaboration to ensure high-quality data collection and reporting. Helps track program performance and organize specialty-specific reporting deliverables. Responds to basic MIPS questions and escalates more complex inquiries to senior staff or leadership.
Cross-Specialty Support & Collaboration
Works with internal teams across multiple specialties to ensure consistent application of regulatory requirements.
Other Duties
Performs additional administrative, auditing, or regulatory tasks as assigned. Supports continuous improvement efforts within the Regulatory Affairs team.
Education and Experience Requirements
High school diploma or equivalent required; associate or bachelor's degree preferred. Current Certified Professional Coder (CPC) credential required. Minimum of three years working with the MIPS program is required. Minimum of two years administrative experience. Familiarity with Radiology, Anesthesia, Emergency Medicine, or Hospital Medicine coding is a plus but not required.
Knowledge, Skills, and Abilities
Strong written and verbal communication skills. Proficiency in Microsoft Office and Windows-based applications with special focus on Excel. High level of accuracy, attention to detail, and organizational skill. Ability to analyze data, identify patterns, and document findings clearly. Strong time management and task prioritization capabilities. Ability to produce clear, professional materials for internal or external audiences. Self-directed, proactive, and able to work independently with minimal supervision. Comfortable in a fast-paced, deadline-driven environment.
Compensation
Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons.
This position is also eligible for a discretionary incentive bonus in accordance with company policies.
  • New York, New York, United States

Sprachkenntnisse

  • English
Hinweis für Nutzer

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