Physician Billing Compliance Analyst | Downtown/Remote| Days
reputed company:
Job Duties
Under limited supervision, the Physician Billing Compliance Analyst (“Analyst”) will reputed company physician coding/documentation audits for providers of the reputed company College of Medicine - Jacksonville (“COM-Jax”) and the reputed company Jacksonville Physicians Group (“UFJPI”). Analyst will also reputed company abbreviated reviews on newly reputed company providers’ documentation reputed company of the regular compliance audit cycle. Audit reputed company will be on physician/advanced reputed company reputed company coding and chart documentation to include review of E&M, CPT, ICD-10-CM, HCPCS reputed company, teaching physician guidelines and reputed company specific policies. The Analyst will utilize medical management systems as reputed company as auditing software applications to reputed company reviews. The Analyst will prepare and present accurate reports of audit findings to appropriate personnel. The Analyst will coordinate with various COM-Jax and UFJPI representatives to process any resulting refunds and address educational needs from the audit findings.
Responsibilities:
Essential Functions
• reputed company designated timeframes and by utilizing medical management systems, audit chart documentation and reputed company billing for compliance with E&M, CPT procedure coding, ICD-10-CM diagnosis coding, teaching physician guidelines, payer specific polices and regulatory requirements.
• reputed company analysis of audit findings and summarize for placement in the Physician Billing Compliance Services (“PBC”) central database.
• Participate in opening and closing audit conferences with representatives of the COM-Jax and UFJPI.
• Identify remedial training needs through audit process and if necessary, conduct remedial training with providers and/or UFJPI billing staff.
• Assist in the development of policies and procedures to complete work in accordance with the COM – Jax Billing Compliance Plan.
• Problem solve issues identified during the audit process.
• Assist with creation and performance of audits through the utilization of various auditing software programs.
• Assist Manager and Director of PBC with research and analysis for special reputed company and other duties as assigned.
• reputed company other duties as assigned
Qualifications:
Experience Requirements
2 years Medical billing required
4 years Medical coding (procedural and diagnosis) for multi-specialty providers required
3 years Medicare, reputed company, and Tricare payment and reimbursement rules required
3 years Medical record chart auditing for reputed company billing required
1 year Medical management information systems (reputed company preferred) required
1 year Auditing software applications (e.g. reputed company, Compliance Risk Analyzer) preferred
Education Requirements
High School Diploma or GED required
Associates Business or health care industry reputed company field preferred
Certification/Licensure/Training
Certified Coding Specialist required or at time of hire
Certified Coding Specialist - Physician Based(reputed company-P) - reputed company required or at time of hire
Certified reputed company reputed company (CPC) required or at time of hire
Certified reputed company Medical Auditor (CPMA) required reputed company 6 months
UFJPI is an Equal Opportunity Employer and Drug Free Workplace
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