Audit and Billing Compliance Specialist

University of Arkansas•Little Rock, AR

3d•Onsite

About The Position

The Audit & Billing Compliance Specialist, under the general direction of the Director of Clinical Billing Compliance, conducts internal monitoring and auditing functions on policies and procedures. Reviews medical records and billing system programs to determine procedure code and billing accuracy and ensures that all federal, state and UAMS guidelines for coding and billing are followed. Provides education and training to UAMS billing providers and staff in reference to audit results.

Requirements

Bachelor's degree plus three (3) years of experience in professional coding/auditing functions, or High School diploma/GED plus seven (7) years of experience in professional coding/auditing functions required.
Must have one of the following CURRENT coding certifications: Certified Professional Coder (CPC), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Registered Nurse (RN), Certified Coding Specialist – Physician-based (CCS-P), or Certified Coding Specialist (CCS)
Must have demonstrated ability to present information verbally and have strong written communication skills with attention to detail.
Persons must have proof of legal authority to work in the United States on the first day of employment.

Nice To Haves

Degree in Health Information Management, Healthcare Administration, or related field
Surgical coding experience or previous Evaluation and Management (E&M) code audit experience.

Responsibilities

Manages compliance issues for assigned departments.
Conducts professional coding & billing audit/monitoring functions according to the audit plan schedule.
Reviews medical record documentation and billing system processes to determine the accuracy of the revenue cycle.
Serves as a contact for issues that arise within assigned programs, as a resource for coding and billing questions, and for reporting issues.
This position works very independently and must have good decision-making skills.
Meets with billing providers to discuss areas of improvement in documentation for appropriate reimbursement.
Develops and presents educational in-service programs according to the audit plan schedule.
Maintains tracking program to ensure attendance at mandatory sessions.
Keeps abreast of current trends, problems, and activities relating to billing documentation and coding.
Proficient and keeps current with all COM/UAMS billing policies and procedures and applicable federal and state regulations.
Serves as a resource to assigned departments on current regulations and documentation issues.
Research issues and provides professional coding guidance.
Performs ad hoc audits and follow-up functions for areas of compliance concerns which may include external audits.
Participates in special projects as assigned by the Director of Clinical Billing Compliance and/or the Associate Vice Chancellor & Chief Compliance Officer and other duties as assigned.