Compliance Audit Analyst

United States, North America
Feb 15, 2014
About The Unit: The University of Chicago Medicine is committed to promoting conduct that is responsible, ethically sound, and compliant with applicable law. The University of Chicago Medicine (UCM), through the Office of Corporate Compliance (OCC), fosters a corporate culture of ethical behavior and integrity in all matters related to compliance with the laws and regulations that govern the delivery and billing of health care. The OCC administers a compliance program that places particular emphasis on compliance with billing, coding, and documentation requirements. Additionally, the OCC, through the HIPAA Program , supports compliance with the privacy and security standards set forth in the Health Insurance Portability and Accountability Act of 1996. Finally, the OCC actively participates in UCM research compliance and conflict of interest management initiatives.

Unit Job Summary: Compliance audit initiatives include physician and facility documentation audits as well as preparation of guidance documents and tools to assist UCM faculty and staff in appropriate billing, coding and documentation. The audit program looks at facility and professional fee billing, coding, and documentation. The audits to be performed each year are identified based on the then-current Office of Inspector General Workplan and compliance risk analyses. Customers include faculty, senior leadership, clinical and non-clinical staff, and students at the University of Chicago Medicine and Biological Sciences Division. Reporting to the Director of Compliance Audit and Education Services, the Compliance Audit Analyst is responsible for the timely and effective completion of Health Care Integrity Program documentation audits and risk assessment projects for coding, documentation and billing accuracy as identified by the organization, OCC, and the Office of the Inspector General. The specifics of the audits are outlined in related annual work plans.

Unit Education: Associate or Bachelor's degree in health administration, health information management, nursing or other related field required. AHIMA or AAPC certification (RHIA, RHIT, CCS, and CPC) to demonstrate coding expertise is preferred.

Unit Experience: Knowledge of state, federal, local, and payer-specific regulations and policies pertaining to documentation, coding, and billing is required. Minimum of three years of experience in healthcare compliance, healthcare operations or billing, coding and/or documentation auditing in a health care organization is preferred. Experience with GE Centricity Business, Centricity Enterprise and Epic preferred.

Unit Job Function Competencies: Analytical skills required. Problem-solving skills required. Decision-making skills required. Attention to detail required. Organizational skills required. Interpersonal skills required. Ability to work independently with a high degree of initiative required. Ability to work as part of a team required. Ability to maintain confidentiality required. Ability to work on multiple projects simultaneously, set priorities, and meet deadlines required. Ability to manage stressful situations required. Knowledge of database management software required. Demonstrated capacity to work independently in an organized, detailed manner while maintaining a collaborative team environment is required. Ability to think abstractly and concretely required. Ability to develop reports, presentations, and spreadsheets required. Strong computer skills including the ability to effectively use software applications such as Microsoft Word, Excel, Outlook, PowerPoint, Access and Internet Explorer is required. Outstanding verbal and written communication skills is required. Experience in handling complex organizational projects; and an excellent problem identification and solution skill to address difficult, complex issues is required. Ability to coordinate the work of others preferred. Knowledge of relevant federal, state and local compliance laws and regulations preferred.