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Billing and Coding Compliance Specialist
2 months ago
Job Summary: We are seeking a highly skilled Billing and Coding Compliance Analyst & Educator to join our team at The Rector & Visitors of the University of Virginia. This role is responsible for ensuring compliance with laws and regulations governing Federal healthcare programs, managing billing and coding investigations, and conducting education and training for billing providers and departments.
Key Responsibilities:
- Prepare the annual risk assessment and compliance work plan.
- Conduct billing and coding-related investigations at UVA Community Health entities.
- Manage and/or conduct billing and coding reviews conducted pursuant to the Compliance and Privacy Office's compliance work plan.
- Design and perform billing and coding-related education and training.
- Collaborate with regulatory/compliance functions and staff throughout UVA Community Health to ensure compliance risk assessment captures operational risks and mitigation plans are created and implemented as necessary.
- Manage billing and coding-related reviews conducted by external vendors/auditors.
- Serve as the UVA Community Health Compliance and Privacy Office's primary contact for billing and coding-related questions and advice.
- Provide 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.
- Work with UVA Community Health departments to ensure timely refunds of any overpayments to Federal program payors.
- Prepare reports for the Compliance Committee and recommend improvements/solutions, guidance, and remedies.
- Work in cooperation with executive staff, physicians, and clinical department management to enhance billing quality in a manner that ensures compliance with government regulations and optimizes revenue for the clinical practice.
Requirements:
- Bachelor's Degree Preferred.
- 5 years of direct compliance audit and/or investigation experience in a physician and/or hospital billing environment or similar setting required.
- Experience in compliance hospital and physician billing required.
- Certified Professional Coder (CPC), AAPC or Certified Coding Specialist (CCS), AHIMA, required.
- Personal computers, hardware, and software. Microsoft Office Programs (i.e., Teams, Windows, Outlook, Work, Excel, etc.). Video conferencing (WebEx, Zoom, etc). EPIC experience required.
Physical Demands:
The job requires frequent sitting, standing, walking, and bending/stooping. Frequent repetitive body movements. Proficient communicative, auditory, and visual skills. Attention to detail and ability to write legibly. Ability to lift/push/pull up to 20 lbs. occasionally.
Other:
- May require the use of safety equipment, such as HEPA mask, for infection prevention: No.
- On call responsibilities as directed: No.
- Ability to travel between campus buildings, remote facilities, and out of town as needed: Yes.
