Senior Billing and Coding Compliance Analyst & Educator

University of Virginia

1d•Hybrid

About The Position

Reporting to the UVA Health Compliance and Privacy Office Billing and Coding Manager, the Sr Billing and Coding Compliance Analyst and Educator is responsible for working to ensure that UVA Health and UVA Community Health complies with the laws and regulations governing Federal healthcare programs (e.g., Medicare, Medicaid). This position is responsible for managing and/or conducting UVA Health’s professional and facility billing and coding investigations and reviews across the UVA Health system and conducting post-review education for UVA Health billing providers and departments. The position monitors and collaborates with compliance and operational staff across UVA Health entities (e.g., UVA Medical Center, UVA Community Health, UPG), UVA Health Revenue Cycle, and any external vendors hired to conduct compliance reviews relating to billing investigations or compliance work plans.

Requirements

Bachelor’s degree required.
5+ years of relevant professional experience required.
Certified Professional Coder (CPC), AAPC or Certified Coding Specialist (CCS), AHIMA, required.
Other similar coding certifications may be considered.

Responsibilities

Works to prepare the annual risk assessment and compliance work plan.
Conducts billing and coding-related investigations at all UVA Health and UVA Community Health entities.
Conducts and/or manages billing and coding reviews conducted pursuant to the Compliance and Privacy Office’s compliance work plan.
Designs and performs billing and coding-related education and training.
Collaborates with regulatory/compliance functions and staff throughout UVA Health to ensure that the compliance risk assessment captures operational risks and that mitigation plans are created and implemented as necessary.
Manages (as applicable) billing and coding related reviews conducted by external vendors/auditors.
Provides oversight and guidance to the development of policies and procedures surrounding documentation, charge capture, coding, and charge entry to ensure compliance with government and payer requirements and to ensure optimization of clinician revenue.
Works with UVA Health departments to ensure timely refunds of any overpayments to Federal program payors.
Prepares reports for the entity compliance steering committees, and recommends improvements / solutions, guidance, and remedies.
Works in cooperation with the executive staff, physicians, and clinical department management to enhance billing quality in a manner that will ensure compliance with government regulations, payer requirements and optimize revenue for the clinical practice.
Completes other projects and duties as assigned by Director and the Chief Corporate Compliance and Privacy Officer.