Audit and Billing Compliance Specialist

Summary of Job Duties

The Audit & Billing Compliance Specialist works under the general direction of the Clinical Billing Compliance Director and reviews medical records and billing system programs to determine coding and billing accuracy and to ensure that all federal and state guidelines for coding and billing are followed. Conducts inpatient and outpatient coding and billing audit functions according to the audit plan schedule with the focus on hospital billing according to the Center for Medicare and Medicaid Systems (CMS) laws and regulations. Provides education and training to coding staff as well as ancillary department staff.

Qualifications

• Minimum Qualifications: Baccalaureate degree plus 3 years’ experience in inpatient and outpatient coding/auditing functions OR High School diploma plus 7 years’ experience in inpatient and outpatient coding/auditing functions.

• Must have one of the following CURRENT coding certifications: Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT).

• Must have demonstrated ability to present information verbally and have strong written communication skills with attention to detail.

• Must have the ability to make reasonable decisions based upon the information gathered, interpret regulatory information and deliver learned information to physicians.

• Performs external agency and special audits as needed.

• Writes RAC appeal letters for DRG changes.

• Communicates with regulatory agencies (Medicaid, Novitas Solutions, etc.) as necessary for clarification of regulations or for assistance with audit issues or coding issues as needed.

• Participates in special projects as assigned by the Senior Director of Clinical Billing Compliance and/or the Associate Vice Chancellor for Institutional Compliance/Chief Compliance Officer and other duties as assigned.

Additional Information

Salary Information: Commensurate with education and experience.

Required Documents to Apply

• List of three Professional References (name, email, business title)
• Resume

Optional Documents

• Proof of Veteran Status

Special Instructions to Applicants

• This position requires at least one of the following coding certifications in CURRENT status: Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT)

Recruitment Contact Information

Please contact askrecruitment@uams.edu for any recruiting related questions.

All application materials must be uploaded to the University of Arkansas System Career Site

https://uasys.wd5.myworkdayjobs.com/UASYS

Please do not send to listed recruitment contact.

Pre-employment Screening Requirements

• No Background Check Required

This position is subject to pre-employment screening (criminal background, drug testing, and/or education verification).

Constant Physical Activity

• Manipulate items with fingers, including keyboarding

Frequent Physical Activity

• Hearing, Talking

Occasional Physical Activity

• Reaching, Standing, Walking