Compliance Audit Specialist III

Job no: 514911
Work type: Staff Full-Time
Location: Main Campus (Gainesville, FL)
Categories: Health Profession, Veteran's Preference Eligible
Department:29011800 - MD-PHYSICIAN BILL COMPLIANCE

Classification Title:

Compliance Audit Specialist III

Job Description:

As part of the University of Florida College of Medicine (COM) Compliance Office, the Compliance Audit Specialist III position conducts regulatory compliance audits of the College of Medicine departments, institutes and centers to ensure data integrity and compliance with federal and state regulations. This includes reviewing medical and billing records to determine if service and documentation requirements are met. Acts as auditor-in-charge and works in collaboration with the Compliance Audit Specialist manager and Director of Physician Billing Compliance to provide input and assist in the development of any applicable training and education content.

Duties Include:

• Conducts compliance audits of the University of Florida College of Medicine departments, institutes, and centers to ensure data integrity, compliance with federal and state regulations pertaining to, but not limited to provider billing services. Reviews medical and billing records to determine if service and documentation requirements are met. Clearly documents findings related to work performed. Communicate any identified patterns of error that may create institutional risk.
• Analyzes data using CRA-predictive analytic software and MD Audit programs. Develops metrics that provide data for process measurement, identifying indicators for future improvement opportunities.
• Drafts audit findings report and organizes of documentation to support and communicate audit findings. May direct/supervise clerical search of paper or electronic health records. These findings may lead to substantive refunds to the College of Medicine, and/or disciplinary action for faculty, residents, non-physician providers and operational staff.
• Drafts summary reports, communications with physicians, compilation of findings, discussion of findings. Familiarizes with the structure of our clinical practice and participates in recommendations on educational and internal control policies to improve compliance plan effectiveness and operational outcomes.
• Acts as auditor-in-charge of segments of audit work plan, responsible for the timely completion of work. May direct/supervise clerical search of paper or electronic health records.
• Assist with the development of training sessions for providers, professional fee billing staff and others on a regularly scheduled or ad hoc basis.
• Responsible for current reading to remain appraised of coding changes, and seek institutional interpretations. Researches current federal, state and payer documentation, billing and coding rules and regulations.

Expected Salary:

$24.00 - $27.00; commensurate education and experience

Pay Range Based on Market:

(Annualized)

Lower reference point: $38,900 Midpoint: $50,500 Upper Reference point: $62,100

Minimum Requirements:

- High school diploma, or equivalent, and five (5) years of relevant experience. Appropriate college course work may substitute at an equivalent rate for the required experience.

- Certified Professional Coder (CPC)/ American Academy of Professional Coders or Certified Coding Specialist (CCS-P) (American Health Information Management Association) or Certified Coding Associate (CCA) (American Health Information Management Association) or Certified in Healthcare Compliance (CHC) or Certified in Healthcare Research Compliance (CHRC) or Certified in Healthcare Privacy Compliance (CHPC) or Certified Compliance & Ethics Professional (CCEP) or Certified Compliance & Ethics Professional-International (CCEP-I) is required.

Preferred Qualifications:

• High school diploma and seven (7) years of appropriate experience. Appropriate college course work or vocational /technical training may substitute at an equivalent rate for the required experience.
• Knowledge and experience with electronic health records, databases, and Microsoft Word.
• Extensive coding experience in an academic setting.
• Excellent proofreading abilities and attention to detail.
• Demonstrated ability to handle telephone communication in appropriate manner.
• Flexible and willing to assume new tasks
• Act in a mature manner when dealing with staff and general public.
• Knowledge of related clinical and business practices, policies, and procedures for billing and collection of professional fee services, and audit processes preferred.
• Experience in review of medical record documentation in an electronic health record.

Special Instructions to Applicants:

In order to be considered, you must upload your cover letter, resume and list of 3 professional references.

This position is eligible for veteran’s preference. If you are claiming veteran’s preference, please upload a copy of your DD 214 Member Copy 4 with your application for consideration. See our Veteran's Preference Page for more specific information.

This is a time-limited position.

Application must be submitted by 11:55 p.m. (ET) of the posting end date.

Health Assessment Required:No

Advertised: 19 Oct 2020 Eastern Daylight Time
Applications close: 26 Oct 2020 Eastern Daylight Time