What you will do:
Works to utilize the department’s resources for analytical auditing and monitoring activities related to University Health’s compliance program and help to develop an annual audit plan under the supervision of the Chief Compliance/HIPAA Officer. The scope of audits will primarily be in the areas of coding, billing, medical record documentation, claims, clinical data, and reports as they relate to the revenue cycle. Will routinely review and evaluate University Health’s internal control structures within revenue cycle activities to ensure they adequately prevent and detect errors, fraud, waste and abuse. Strives to protect the department’s reputation for creditability and objectivity. Handles all personal contacts with professionalism, efficiency and integrity while preserving the confidential nature of information.
- Bachelor’s degree from an accredited college or university strongly preferred.
- Certification from AAPC or AHIMA as a Certified Professional Coder (CPC) and Certified Professional Medical Record Auditor (CMPA), Certified Coding Specialist (CCS), Registered Health Information Administrator (RHIA), or a Registered Health Information Technician (RHIT) is required.
- Minimum three years’ experience performing various claims validation reviews in a multi-specialty outpatient/Ambulatory Surgery Center is strongly preferred. Expert knowledge of ICD, CPT, HCPCS coding classifications required and DRG, APC and ASC payment methodology preferred.
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