Coding/Compliance Nurse Specialist- Billing Compliance- University Hospital
2 weeks ago
USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community.
USA Health is changing how medical care, education and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists and researchers provide the region's most advanced medicine at multiple facilities, campuses, clinics and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall wellbeing of our community.
Responsibilities:
This is responsible professional nursing work providing audit and review of compliance and reimbursement procedures for the University of South Alabama Health Services Foundation. An employee in a position allocated to this classification is responsible for researching issues requiring medical decision making related to medical coding; providing medical coding/documentation coaching and education to providers and staff; auditing medical records; analyzing data and preparing reports; work is performed under the general supervision of a higher level administrative employee and is review through reports and conferences for achievement of desired goals; researches, resolves, and documents issues requiring medical decision-making; identifies deficiencies in medical coding and documentation and provides coaching and education to coding staff and providers; assists in the implementation and maintenance of various staff training related to medical necessity and coding; travels to various clinics to perform audits of medical records; analyzes and presents results of audits to appropriate administration, department chairs, and faculty; attends seminars and conferences as required; stays abreast of current regulations and guidelines related to Medicare, Medicaid, Tricare, Blue Cross and Blue Shield, and various other insurance carriers; assists in developing billing policies and procedures based on payer-rules; serves as resource to medical staff on issues related to coding and documentation; regular and prompt attendance; ability to work schedule as defined and overtime as required; related duties as required.
Qualifications:
Graduation from an accredited school of nursing meeting the minimum standards set by the state of Alabama, one year of professional nursing experience, and licensure with the state of Alabama as a registered nurse. Certification as a Certified Professional Coder must be obtained within one year of employment. Experience in medical coding, auditing and training is preferred.
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