Requisition 10000622

Professional Career Opportunities

Telephone Job Line: (214) 648-5627

BILLING COMPLIANCE AUDITOR_II

Posted Date Thu Nov 05, 2009

Closing Date Wed Nov 11, 2009 or until filled

Salary * Negotiable *

FLSA Status Exempt

Department Office Of Compliance

Job Category Professional

Hours 8A - 5P

Requisition Number 10000622

Position Number 43308

Experience & Education Required (any one of the following):

1. Bachelor degree in business, healthcare administration, regulatory compliance, or equivalent; certification as one of the following: Registered Records Administrator (RRA), Registered Health Informa- tion Administrator (RHIA), Advanced Records Technician (ART), or licensure as a registered nurse by the Texas Board of Nursing;
2. certified as a Certified Professional Coder (CPC), Certified Coding Specialist (CCS) or a Certified Medical Coder (CMC); and, five (5) years of professional experience in physician billing or coding are required.

Skills And Abilities Medical Terminology
Effective Communications Skills
Auditing
Medical Billing
Personal Computer
ICD9 Coding
Customer Service

Security This position is security-sensitive and subject to Texas Education Code §51.215, which authorizes UT Southwestern to obtain criminal history record information.

Job Duties 1. Plans and conducts annual clinical department billing compliance audits by selecting statistically valid sample of invoices, collecting documents, analyzing standards, completing tally sheets, and reviewing charts to invoices. Ensures statistical selections are validated and audit tally sheets are accurate.

2. Prepares departmental summaries based on billing compliance audit and presents findings to department staff, Billing Compliance Officer, and Billing Compliance Advisory Committee.

3. Identifies risk areas requiring additional review by evaluating statistical reports, summaries, and other information pertaining to billing compliance; performs focused audits in addition to annual audit when necessary.

4. Develops corrective action plans to assist in resolving problems related to billing compliance.

5. Assists clinical departments with revisions to departmental compliance plans and compliance training.

6. Investigates telephone calls, written notes, and other reports of possible noncompliance to determine university's exposure to corrective action by payers.

7. Provides Medicare program and claim coding analysis by contacting Medicare representatives, attending seminars, and completing summaries for clinical department requesting information; ensures information obtained from carrier is documented and validated.

8. Maintains expertise in accepted coding, documentation, and compliance procedures by initiating contact with other organizations and associations, attending training workshops, and self-study of reference materials.

9. Documents findings by writing summary forms, constructing opinion letters, and maintaining audit files.

10. Interacts with Billing Compliance Committee to identify and address compliance needs, make recommendations for corrective and/or disciplinary action, and perform risk assessments of departmental coding and charge capture activities.

11. Performs other duties as assigned.

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Return to Professional Career Opportunities

Posted Date	Thu Nov 05, 2009
Closing Date	Wed Nov 11, 2009 or until filled
Salary	* Negotiable *
FLSA Status	Exempt
Department	Office Of Compliance
Job Category	Professional
Hours	8A - 5P
Requisition Number	10000622
Position Number	43308
Experience & Education Required (any one of the following):	1. Bachelor degree in business, healthcare administration, regulatory compliance, or equivalent; certification as one of the following: Registered Records Administrator (RRA), Registered Health Informa- tion Administrator (RHIA), Advanced Records Technician (ART), or licensure as a registered nurse by the Texas Board of Nursing; 2. certified as a Certified Professional Coder (CPC), Certified Coding Specialist (CCS) or a Certified Medical Coder (CMC); and, five (5) years of professional experience in physician billing or coding are required.
Skills And Abilities	Medical Terminology Effective Communications Skills Auditing Medical Billing Personal Computer ICD9 Coding Customer Service
Security	This position is security-sensitive and subject to Texas Education Code §51.215, which authorizes UT Southwestern to obtain criminal history record information.
Job Duties	1. Plans and conducts annual clinical department billing compliance audits by selecting statistically valid sample of invoices, collecting documents, analyzing standards, completing tally sheets, and reviewing charts to invoices. Ensures statistical selections are validated and audit tally sheets are accurate. 2. Prepares departmental summaries based on billing compliance audit and presents findings to department staff, Billing Compliance Officer, and Billing Compliance Advisory Committee. 3. Identifies risk areas requiring additional review by evaluating statistical reports, summaries, and other information pertaining to billing compliance; performs focused audits in addition to annual audit when necessary. 4. Develops corrective action plans to assist in resolving problems related to billing compliance. 5. Assists clinical departments with revisions to departmental compliance plans and compliance training. 6. Investigates telephone calls, written notes, and other reports of possible noncompliance to determine university's exposure to corrective action by payers. 7. Provides Medicare program and claim coding analysis by contacting Medicare representatives, attending seminars, and completing summaries for clinical department requesting information; ensures information obtained from carrier is documented and validated. 8. Maintains expertise in accepted coding, documentation, and compliance procedures by initiating contact with other organizations and associations, attending training workshops, and self-study of reference materials. 9. Documents findings by writing summary forms, constructing opinion letters, and maintaining audit files. 10. Interacts with Billing Compliance Committee to identify and address compliance needs, make recommendations for corrective and/or disciplinary action, and perform risk assessments of departmental coding and charge capture activities. 11. Performs other duties as assigned.
Comments