Posting Details

Posting Details

Posting Number S03000P Working Title Coding and Compliance Auditor Department UHC Business Services About the University of Georgia

The University of Georgia (UGA), a land-grant and sea-grant university with statewide commitments and responsibilities is the state’s oldest, most comprehensive, and most diversified institution of higher education (http://www.uga.edu/). UGA is currently ranked among the top 20 public universities in U.S. News & World Report. The University’s main campus is located in Athens, approximately 65 miles northeast of Atlanta, with extended campuses in Atlanta, Griffin, Gwinnett, and Tifton. UGA was founded in 1785 by the Georgia General Assembly as the first state-chartered University in the country. UGA employs approximately 1,800 full-time instructional faculty and more than 7,600 full-time staff. The University’s enrollment exceeds 36,000 students including over 27,500 undergraduates and over 8,500 graduate and professional students. Academic programs reside in 17 schools and colleges, as well as a medical partnership with Augusta University housed on the UGA Health Sciences Campus in Athens.

About the College/Unit/Department College/Unit/Department website https://www.uhs.uga.edu/ Posting Type External Retirement Plan TRS Employment Type Employee Benefits Eligibility Benefits Eligible Full/Part time Full Time Work Schedule Additional Schedule Information

M-F, 8:00am-5:00pm

Advertised Salary Commensurate with experience Posting Date 04/25/2019 Open until filled Yes Closing Date Proposed Starting Date 06/01/2019 Special Instructions to Applicants Location of Vacancy Athens Area EEO Policy Statement

The University of Georgia is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, ethnicity, age, genetic information, disability, gender identity, sexual orientation or protected veteran status.

Position Information

Classification Title Accounting Paraprofessional/Professional Pay Grade FLSA Exempt Job Family FTE 1.00 Minimum Qualifications

Requires technical knowledge in the field acquired through an apprenticeship, a 2-year degree, or professional certificate. Please contact your Human Resources office for an evaluation of education/experience in lieu of the required minimum qualifications.

Preferred Qualifications

UHC Minimum: Bachelor’s or Associate degree in English, Business Administration or other related field from an accredited college or university. Certified Professional Coder (CPC) certification required, which includes staying current with AAPC (American Academy of Professional Coders) membership. Minimum of five (5) years’ experience in a healthcare environment with direct experience with financial counseling, insurance billing and follow-up. Knowledge of medical terminology related to Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS) and International Statistical Classification of Diseases (ICD-10).

Certified Professional Medical Auditor (CPMA) certification preferred. Three (3) years experience in a multispecialty practice or hospital setting. Must possess strong customer service and communication skills, excellent verbal skills, computer skills (Microsoft Office), strong basic math skills and possess the ability to handle multiple tasks with flexibility and attention to detail.

Position Summary

The Coding and Compliance Auditor conducts coding, billing and documentation compliance audits within established timeframe. Develops and maintains policies and procedures for coding and coding guidelines. Assists in developing, presenting and executing educational programs for clinicians, related to coding matters. Develops, organizes and maintains spreadsheet data and/or worksheets related to coding and documentation compliance.

Please note this is a full time 10 month position

Knowledge, Skills, Abilities and/or Competencies

Excellent interpersonal and communication skills. Have an understanding of all payers as it relates to billing and have the knowledge of payor reimbursement methodology. Competency with Electronic Medical Record (EMR) systems. Effectively and professionally communicate with other departments and co-workers to resolve coding and claim issues.
- Certified Professional Coder (CPC) certification required, which includes staying current with AAPC (American Academy of Professional Coders) membership. Experience in a healthcare environment with direct experience with financial counseling, insurance billing and follow-up. Knowledge of medical terminology related to Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS) and International Statistical Classification of Diseases (ICD-10).

Strong customer service and communication skills, excellent verbal skills, computer skills (Microsoft Office), strong basic math skills and possess the ability to handle multiple tasks with flexibility and attention to detail.

Physical Demands

Sit for long periods of time (4-8 hours). Perform fine motor skills and read.

Is driving required to perform essential duties outlined in this position? (This does not include infrequent trips) The successful candidate would have to provide proof that s/he has a valid driver's license when offered employment. Does this position have financial responsibilities? Yes Does this position require a P-Card? No Is having a P-Card an essential function of this position? No Credit and P-Card policy

Be advised a credit check will be required for all positions with financial responsibilities. For additional information about the credit check criteria, visit the UGA Credit Background Check website.

Duties/Responsibilities

Duties/Responsibilities

Conduct coding, billing and documentation compliance audits within established timeframe:
Audits the accuracy and completeness of diagnosis and procedure coding. Identify incomplete documentation in the medical record and formulate a clinician query to obtain missing documentation and/or clarification to accurately complete the coding process. Prepares periodic reports for clinical staff identifying unbilled charges due to inadequate documentation. Stay abreast of relevant billing and coding questions concerning the current areas of an audit focus

Percentage of time 40 Duties/Responsibilities

Duties/Responsibilities

Develop and maintain policies and procedures for coding and coding guidelines:
Provides input and guidance in the development and review of detailed audit programs and reports to improve audit effectiveness and efficiency. Compliance and Regulatory guidelines include: Fraud and Abuse, Federal False Claims Act, Anti-Kickback Law, Stark Law, Exclusion Statute, Civil Monetary Penalties Law, Office of Inspector General (OIG), Centers for Medicare and Medicaid Services (CMS)

Percentage of time 25 Duties/Responsibilities

Duties/Responsibilities

Assist in developing, presenting and executing educational programs for clinicians, related to coding matters:
Advise and instruct coders/providers regarding billing and documentation policies, procedures, and regulations. Interacts with providers regarding conflicting, ambiguous, or non-specific medical documentation, to obtain clarification. Proficient in organizing and compiling documentation and thoughts in order to provide supported opinions to the medical providers on audit findings.

Percentage of time 25 Duties/Responsibilities

Duties/Responsibilities

Develop, organize and maintain spreadsheet data and/or worksheets related to coding and documentation compliance:
Collection of data to be used for analytics (e.g., statistical sampling, identification of trends). Sharing of this data with billing providers as part of utilization review.

Percentage of time 10 Posting Specific Questions

Required fields are indicated with an asterisk (*).

1. How many years of experience do you have in this type of position?
   • 0-1
   • 1-3
   • 3-5
   • 5-7
   • 7+

Applicant Documents Required Documents

Optional Documents

1. Resume/CV
2. Cover Letter