Perform provider and facility documentation audits across the broader UChicago Medicine health system and generates reports for audited providers, department leadership, and organizational leadership. Using quality assurance procedures ensures the accuracy of data entered in the audit software database. Analyze audit data and outcomes for the purpose of developing educational materials, work plans, and corrective action and process improvement methods. Serve as a key liaison with departments for follow-up of recommendations.
Serve as lead for focused audits involving the audit team, directly contributing to the identification of audit scopes and the creation and enhancement of the auditing processes.
Support compliance-related inquiries and investigations involving the risk & data team, and external departments. Assist with monitoring government audit activity.Â
Conduct provider education sessions for the purpose of educating and training faculty, non-physician providers, residents/fellows, coding/billing, and administrative personnel in CPT/HCPCS/ICD-10-CM coding, Health Information Management compliance, Centers for Medicare and Medicaid (CMS) Physicians at Teaching Hospitals (PATH) rules, and billing requirements as identified in their documentation audits. Support in the development of education and communication materials, including guidance documents, presentations, newsletters, etc., based on audit results, for dissemination to practitioners, department billing personnel, and other compliance staff.
Stay abreast of current trends related to healthcare compliance regulations for billing and coding; Educate faculty and staff on coding, billing, and documentation guidelines as identified in audits.
Serve as the content expert for audit software users, both internal and external to the department and organization.
Guides the implementation of compliance activities designated by the University's strategic plans. Monitors University compliance with regulations and laws.
May provide confidential counseling and expertise to those who feel they have experienced unlawful treatment based on University programs and activities.
Performs other related work as needed.
Preferred Qualificationsâ‹
Education:
Bachelor's degree in health administration, health information management, nursing, or another related field.
Experience:
Academic medical center and/or health care consulting experience.
Experience with Epic electronic medical software.
Licenses and Certifications:
AHIMA or AAPC certification (RHIA, RHIT, CCS, and CPC) to demonstrate coding expertise.
Strong computer skills including the ability to effectively use software applications such as Microsoft Word, Excel, Outlook, PowerPoint, Access, and Internet Explorer.
Technical Skills or Knowledge:
Strong computer skills including the ability to effectively use software applications such as Microsoft Word, Excel, Outlook, PowerPoint, Access, and Internet Explorer.
Preferred Competencies
Knowledge of state, federal, local, and payer-specific regulations and policies pertaining to documentation, coding, and billing.
Knowledge of hospital and professional services reimbursement systems (OPPS, IPPS, PFS).
Demonstrated capacity to work independently in an organized, detailed manner while maintaining a collaborative team environment.
Strong project management skills.
Attention to detail and ability to lead/motivate.
Ability to think abstractly and concretely.
Ability to develop reports, presentations, and spreadsheets.
Outstanding verbal and written communication skills.
Experience in handling complex organizational projects.
Excellent problem identification and solution skill to address difficult, complex issues.
Application Documents
Resume (required)
Cover Letter (preferred)
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Staff Job seekers in need of a reasonable accommodation to complete the application process should call 773-702-5800 or submit a request via the Applicant Inquiry Form.
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