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

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U.S. Urology Partners

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501 - 1000 employés

⚕️ Assurance santé

Healthcare Insurance

U. S. Urology Partners est l'un des plus grands prestataires indépendants de services d'urologie et de spécialités connexes aux États-Unis. L'entreprise se concentre sur l'aide aux cabinets d'urologie pour qu'ils conservent leur indépendance tout en fournissant des soins de haute qualité aux patients. En offrant des ressources de gestion et financières étendues, U. S. Urology Partners permet aux cabinets de se concentrer sur les soins aux patients sans être contraints de devenir subordonnés dans de grands systèmes hospitaliers. Ils assistent avec des aspects opérationnels tels que l'informatique, les technologies de l'information, la conformité, le juridique et plus encore, permettant ainsi aux médecins de se concentrer sur la médecine plutôt que sur les tâches administratives.

Description

• 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.

🎯 Exigences

• 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.

🏖️ Avantages

• 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.