Details
Posted: 08-May-22
Location: St. Louis, Missouri
Type: Full-time
Salary: Open
Scheduled Hours
40
Position Summary
Position is responsible for conducting comprehensive and focused audits in a variety of Washington University School of Medicine multi-disciplinary clinical practices. The purpose of the audits is to determine accuracy of coding, documentation, and physician/provider compliance with CPT and ICD-10-CM coding standards, governmental billing regulations, and University policy. The position is responsible for analysis and interpretation of audit data resulting in communication of audit findings through written report.
Job Description
Office environment with physical ability to push/pull/lift approximately 30 pounds, lift/carry medical charts, and walk to various audit locations; position requires local travel to BJC hospital and other faculty locations.
Primary Duties and Responsibilities
Performs audit function of the Washington University School of Medicine Office of Physician Billing Compliance (OPBC). Compliance analyst shall:
- Follows audit plan/schedule as outlined in the OPBC fiscal year work plan as approved by the Compliance Director/Compliance Committee.
- Identifies and selects audit sample via IDX billing system query and secures selected medical records from inpatient and outpatient locations.
- Reviews medical record documentation for compliance with CPT and ICD-10-CM coding standards, University policy, and Center for Medicare and Medicaid Services (CMS) regulations, including regulation applicable to physicians in teaching hospitals.
- Analyzes and interprets the data collected.
- Researches issues that arise out of audit findings.
- Prepares reports, as required, to provide an analysis of the data collected and to inform physicians, departmental staff, and/or compliance personnel of findings.
Reports issues of noncompliance identified through the audit process to the Supervisor of Audit Services.
Creates and or modifies all auditing tools and aids to ensure compliance, including modifications necessary to reflect changes in regulations as they occur.
Researches specialty-specific coding/billing issues prior to departmental/divisional audits and keeps abreast of current specialty-specific coding literature and changes in regulation, standard coding practice, and policy.
Notifies Compliance Educator(s) of department/division-specific practices, policies, and procedures that may affect and/or raise compliance issues identified during the audit process.
Ensures audit protocol adheres to the Standards of Ethical Coding as set forth by the American Health Information Management Association and to official coding guidelines.
Special audit and compliance-related projects as assigned.
Preferred Qualifications
- Bachelorâ™s degree.
- Registered Nurse (RN), Registered Health Information Administrator (RHIA) and/or Registered Health Information Technician (RHIT).
- Knowledge of CMS documentation and billing regulations.
- Experience in medical record review for documentation and/or utilization review or continuous quality improvement.
- Diverse clinical background.
- Good communication skills.
- Ability to work independently and in a team.
- ICD-10-CM and CPT coding experience.
- Working knowledge using a personal computer and applications. Specifically, word processing and spreadsheets.
- General knowledge of HIPAA regulations in regards to protecting person health information.
Required Qualifications
Associate degree or equivalent and experience in health care related field.
Grade
C13
Salary Range
$63,300.00 - $98,200.00 / Annually
The salary range reflects base salaries paid for positions in a given job grade across the University. Individual rates within the range will be determined by factors including one's qualifications and performance, equity with others in the department, market rates for positions within the same grade and department budget.
Pre-Employment Screening
All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening.
Benefits Statement
Washington University in St. Louis is committed to providing a comprehensive and competitive benefits package to our employees. Benefits eligibility is subject to employment status, full-time equivalent (FTE) workload, and weekly standard hours. Please visit our website at https://hr.wustl.edu/benefits/ to view a summary of benefits.
EEO/AA Statement
Washington University is an equal opportunity and affirmative action employer. All qualified applicants will receive consideration without regard to an individualâ™s sex, race, color, religion, age, disability status, protected veteran status, national or ethnic origin, gender identity or expression, sexual orientation. Women, minorities, protected veterans and the disabled are strongly encouraged to apply.
Diversity Statement
Washington University is dedicated to building a diverse community of individuals who are committed to contributing to an inclusive environment â“ fostering respect for all and welcoming individuals from diverse backgrounds, experiences and perspectives. Individuals with a commitment to these values are encouraged to apply.
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