Audit and Billing Compliance Specialist

Role Description

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 a 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

• 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).
• Demonstrated ability to present information verbally and have strong written communication skills with attention to detail.
• Ability to make reasonable decisions based upon the information gathered, interpret regulatory information, and deliver learned information to physicians.

Requirements

• Conducts inpatient and outpatient coding & billing audit/monitoring functions according to the audit plan schedule.
• Audits departmental systems and processes to ensure compliance with state and federal laws and regulations.
• Provides audit results to affected areas and educates staff regarding errors.
• Prepares detailed audit reports for the Clinical Billing Compliance Director and Associate Vice Chancellor review.
• Develops and presents educational in-service programs on new regulatory issues for all inpatient and outpatient coders.
• 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.

Benefits

• Health: Medical, Dental and Vision plans available for qualifying staff and family.
• Holiday, Vacation and Sick Leave.
• Education discount for staff and dependents (undergraduate only).
• Retirement: Up to 10% matched contribution from UAMS.
• Basic Life Insurance up to $50,000.
• Career Training and Educational Opportunities.
• Merchant Discounts.
• Concierge prescription delivery on the main campus when using UAMS pharmacy.