Phys Bill Compliance Analyst | Phys Billing Compliance - GA, FL, NC, TN, NH Residents ONLY | Re[...]

University of Florida Jacksonville Physicians, Inc.; Jacksonville (FL); Remote; USD 55,000 - 75,000; Full time

Job summary

Une opportunité passionnante se présente pour devenir Analyste en conformité de facturation médicale au sein d'un groupe médical respecté. En tant qu'Analyste, vous serez chargé de réaliser des audits approfondis des codages et de la documentation des médecins. Votre expertise en facturation médicale et en conformité sera essentielle pour garantir la qualité et le respect des normes réglementaires. Vous travaillerez en collaboration avec divers représentants pour traiter les résultats d'audit et participer à la formation des fournisseurs.

Qualifications

• 2 ans d'expérience en facturation médicale.
• 4 ans en codage médical pour médecins multi-spécialités.
• 3 ans d'audit de dossiers médicaux pour facturation professionnelle.

Responsibilities

• Auditer la documentation des chartes et la facturation professionnelle pour conformité.
• Analyser les résultats d'audit et résumer pour la base de données centrale.
• Identifier les besoins en formation par le processus d'audit.

Skills

Audit médical

Facturation médicale

Analyse des données

Connaissances sur Medicare

Conformité réglementaire

Education

High School Diploma ou GED

Associates en Business ou dans un domaine lié à la santé

Tools

EPIC

MDaudit

Job description

Phys Bill Compliance Analyst | Phys Billing Compliance - GA, FL, NC, TN, NH Residents ONLY | Remote Days

2 days ago Be among the first 25 applicants

Overview

Job Duties

Under limited supervision, the Physician Billing Compliance Analyst (“Analyst”) will perform physician coding/documentation audits for providers of the University of Florida College of Medicine - Jacksonville (“COM-Jax”) and the University of Florida Jacksonville Physicians Group (“UFJPI”). Analyst will also perform abbreviated reviews on newly hired providers’ documentation outside of the regular compliance audit cycle. Audit focus will be on physician/advanced practice professional coding and chart documentation to include review of E&M, CPT, ICD-10-CM, HCPCS Level II, teaching physician guidelines and carrier specific policies. The Analyst will utilize medical management systems as well as auditing software applications to perform reviews. The Analyst will prepare and present accurate reports of audit findings to appropriate personnel. The Analyst will coordinate with various COM-Jax and UFJPI representatives to process any resulting refunds and address educational needs from the audit findings.

Responsibilities

Essential Functions

• Within designated timeframes and by utilizing medical management systems, audit chart documentation and professional billing for compliance with E&M, CPT procedure coding, ICD-10-CM diagnosis coding, teaching physician guidelines, payer specific polices and regulatory requirements.
• Perform analysis of audit findings and summarize for placement in the Physician Billing Compliance Services (“PBC”) central database.
• Participate in opening and closing audit conferences with representatives of the COM-Jax and UFJPI.
• Identify remedial training needs through audit process and if necessary, conduct remedial training with providers and/or UFJPI billing staff.
• Assist in the development of policies and procedures to complete work in accordance with the COM - Jax Billing Compliance Plan.
• Problem solve issues identified during the audit process.
• Assist with creation and performance of audits through the utilization of various auditing software programs.
• Assist Manager and Director of PBC with research and analysis for special projects and other duties as assigned
  
  

Qualifications

Experience Requirements

2 years Medical billing required

4 years Medical coding (procedural and diagnosis) for multi-specialty providers required

3 years Medicare, Medicaid, and Tricare payment and reimbursement rules required

3 years Medical record chart auditing for professional billing required

Preferred Required

1 year Medical management information systems (EPIC preferred) required

1 year Auditing software applications (e.g. MDaudit, Compliance Risk Analyzer) preferred

Education Requirements

High School Diploma or GED required

Associates Business or health care industry related field preferred

Certification/Licensure/Training

Certified Coding Specialist required or at time of hire

Certified Coding Specialist - Physician Based(CCS-P) - AHIMA required or at time of hire

Certified Professional Coder (CPC) required or at time of hire

Certified Professional Medical Auditor (CPMA) required within 6 months

UFJPI is an Equal Opportunity Employer and Drug Free Workplace

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Legal

• Industries

  Hospitals and Health Care

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Coder I | Remote | GA, FL, NC, TN, NH Residents ONLY

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