Senior Billing and Coding Compliance Analyst & Educator

Reporting to the Director of Compliance and Privacy, this role ensures UVA Health complies with laws and regulations governing Federal healthcare programs (e.g., Medicare, Medicaid).

Responsibilities

• Manage and/or conduct UVA Health’s professional and facility billing and coding investigations and reviews.
• Conduct post-review education for UVA Health billing providers and departments.
• Monitor and collaborate with compliance and operational staff across UVA Health entities (e.g., UVA Medical Center, UVA Community Health, UPG) and external vendors conducting compliance reviews.
• Prepare the annual risk assessment and compliance work plan.
• Conduct billing and coding-related investigations at UVA Health entities.
• Conduct and/or manage billing and coding reviews 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 to capture operational risks and implement mitigation plans.
• Manage billing and coding-related reviews conducted by external vendors/auditors.
• Serve as the primary contact for billing and coding-related questions and advice.
• Provide oversight and guidance on policies and procedures for documentation, charge capture, coding, and charge entry to ensure compliance and optimize clinician revenue.
• Work with UVA Health departments to ensure timely refunds of overpayments to Federal program payors.
• Prepare reports for entity compliance steering committees and recommend improvements, solutions, and remedies.
• Work with executive staff, physicians, and clinical department management to enhance billing quality, ensure compliance, and optimize revenue.
• Complete other projects and duties as assigned by the Director and Chief Corporate Compliance and Privacy Officer.

Requirements

• Bachelor’s degree required. In lieu of a bachelor's degree, 9 years of direct compliance audit and/or investigation experience in a physician and/or hospital billing environment or similar setting is required.
• Experience in compliance hospital and physician billing required.
• Certified Professional Coder (CPC), AAPC or Certified Coding Specialist (CCS), AHIMA, required. Other similar coding certifications may be considered.

Physical Demands

This is primarily a sedentary job involving extensive use of desktop computers. The job occasionally requires traveling to attend meetings and programs.

Pay

The pay range for this role is $71,988.80 - $127,890.00 annually. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.