Healthcare Compliance Audit Analyst, CPC, CCS-P, CPMA

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U.S. Urology Partners

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

⚕️ Seguro de Saúde

Healthcare Insurance

A U. S. Urology Partners é um dos maiores provedores independentes do país em urologia e serviços especializados relacionados. A empresa foca em ajudar as práticas de urologia a manterem sua independência ao mesmo tempo em que oferece cuidados de alta qualidade aos pacientes. Oferecendo ampla gestão de saúde e recursos financeiros, a U. S. Urology Partners permite que as práticas médicas concentrem-se no cuidado ao paciente sem serem forçadas a subserviência dentro de sistemas hospitalares maiores. Eles auxiliam em aspectos operacionais, como informática, TI, conformidade, questões legais, entre outros, permitindo que os médicos se concentrem na medicina em vez de em tarefas administrativas.

Descrição

• Conduct physician/provider and facility documentation audits • Ensures accuracy of data entered into the CD Internal Audit Database and prepares reports for audited providers , department leadership, and organization leadership • Analyze audit data and provides summary feedback to clinic and billing staff, making recommendations for improvement • Works with the billing and coding departments to determine charge corrections and refunds resulting from compliance audits • Works closely with the billing department to help minimize denial issues so that appropriate reimbursements are achieved • Receives and responds to audit, documentation, and coding review requests from the billing department • Performs research for numerous billing and coding scenarios • Provide input in the development and improvement of procedures used to complete the audit function • Assist in conducting formal/informal education sessions for the purpose of educating and training physicians , non-physician providers, and other staff • Identify additional opportunities to improve education of physicians, non-physician providers and staff • Working with the billing and coding departments, prepare and produce billing/coding/documentation communication for use as guidance documents, website content, newsletter content, education content, and other communication channels • Develop materials for use in education and communication derived from audit findings for feedback to physicians, department billing staff, and other compliance staff • Based on types of questions/issues received, identify education/awareness opportunities and guidance topics.

🎯 Requisitos

• Experience with using and navigating through an electronic medical record system • Knowledge of state, federal, local, and payer-specific regulations and policies pertaining to documentation, coding, and billing is required • Demonstrated capacity to work independently in an organized, detailed manner while maintaining a collaborative team environment is required • Ability to think abstractly and concretely required • Ability to develop reports, presentations, and spreadsheets required • Strong computer skills including the ability to effectively use software applications such as Microsoft Word, Excel, Outlook, PowerPoint, Access, and Internet Explorer is required • Outstanding verbal and written communication skills is required • Experience in handling complex organizational projects; and an excellent problem identification and solution skill to address difficult, complex issues is required • Ability to gain the trust and confidence of the providers, compliance team and billing staff.

🏖️ Benefícios

• Beyond competitive compensation, our well-rounded benefits package includes a range of comprehensive medical, dental and vision plans • HSA / FSA • 401(k) matching • Employee Assistance Program (EAP) and more.