Principal Compliance Auditor

Job description

University of California, Irvine

Principal Compliance Auditor

The incumbent is responsible for supervising or performing the highest level of analysis to support the Compliance Audit Officer with projects that directly contribute to major department objectives or resolution of major department problems.
Analysis of new issues, proposals, or programs that are considered complex with variables and interrelationships that require knowledge of a wide range of concepts, principles, and practices within the Compliance scope and the skill to apply this knowledge to the development of new programs, methods, approaches, or procedures.
The Principal Analyst is frequently responsible for coordinating these new programs, proposals, or educations with multiple departments or offices.
At this level, analysis focuses on the analytical study itself, such as gathering data, analyzing the issues, and formulating recommendations.
Analysts make formal or informal presentations to management and discuss the project and recommendations.
Perform full scope audits of provider documentation and coding to ensure compliance with Federal and State regulations specific as to an academic teaching institution.
Defines, leads and oversees special investigations including mining and analyzing data using data analytics to identify and investigate trends, outliers and leads; correcting provider deficiencies through various remedial actions.
Develops, implements and continually refines reporting processes, including those supporting regulatory reports and dashboards, as well as trend reports.
Communicates all audit and review findings to physicians, department administrators, billing managers, and coders.
Develops, reviews, and revises operational and administrative policies and procedures ensuring policies comply with regulatory obligations.
Collaborates with other internal stakeholders (e.g., UCI Health Accountable Care Organization, Revenue Integrity, Professional Billing Services, etc.) on process or performance issues related to department activities.
Develops educational materials and presents educational information to the providers and internal coding groups and assists other areas in staff training to enhance proficient coding and documentation.
Provide supervisory support, when needed, to all Professional Fee Billing and Research auditors. This can include managing outstanding audits, daily supervision of projects, providing a consistent audit process, and time reporting.
Serve as a resource for the providers and billing offices to answer compliance questions related to billing and coding for the professional services across a broad spectrum of medical specialties that have diverse criteria for billing and coding.

The University of California, Irvine is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC nondiscrimination policy.

Salary: Monthly $5,463.67 - $7,452.67
Total Hours: 8-5, M-F
Career Position.
Final candidate subject to background check.
As a federal contractor, UC Irvine is required to use E-Verify to confirm the work status of individuals assigned to perform substantial work under certain federal contracts/subcontracts.
Please attach your resume.

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Job No:
Posted: 12/26/2018
Application Due: 1/17/2019
Work Type: