Audit and Billing Compliance Specialist presso University of Arkansas for Medical Sciences
University of Arkansas for Medical Sciences · Little Rock, Stati Uniti d'America · Remote
- Professional
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Closing Date:
Type of Position:
Professional Staff - Fiscal Affairs
Job Type:
Regular
Work Shift:
Sponsorship Available:
Institution Name:
University of Arkansas for Medical Sciences
The University of Arkansas for Medical Sciences (UAMS) has a unique combination of education, research, and clinical programs that encourages and supports teamwork and diversity. We champion being a collaborative health care organization, focused on improving patient care and the lives of Arkansans.
UAMS offers amazing benefits and perks (available for benefits eligible positions only):
- Health: Medical, Dental and Vision plans available for qualifying staff and family
- Holiday, Vacation and Sick Leave
- Education discount for staff and dependents (undergraduate only)
- Retirement: Up to 10% matched contribution from UAMS
- Basic Life Insurance up to $50,000
- Career Training and Educational Opportunities
- Merchant Discounts
- Concierge prescription delivery on the main campus when using UAMS pharmacy
Below you will find the details for the position including any supplementary documentation and questions you should review before applying for the opening. To apply for the position, please click the Apply link/button.
The University of Arkansas is an equal opportunity institution. The University does not discriminate in its education programs or activities (including in admission and employment) on the basis of any category or status protected by law, including age, race, color, national origin, disability, religion, protected veteran status, military service, genetic information, sex, sexual orientation, or pregnancy. Questions or concerns about the application of Title IX, which prohibits discrimination on the basis of sex, may be sent to the University’s Title IX Coordinator and to the U.S. Department of Education Office for Civil Rights.Persons must have proof of legal authority to work in the United States on the first day of employment.
All application information is subject to public disclosure under the Arkansas Freedom of Information Act.
For general application assistance or if you have questions about a job posting, please contact Human Resources at [email protected].
Department:
FIN | CORE Commercial F/U
Department's Website:
Summary of Job Duties:
The Audit & Billing Compliance Specialist is under the general guidance of the Manager, Billing, is responsible for the review of revenue against third-party billing guidelines and provides clinical expertise for questions about charging and clinical practices. Accountable for ensuring the accuracy and integrity of the billing documentation through review providing guidance for all staff in HBS regarding charging and clinical practices. Acts as liaison with clinical departments regarding charging issues, questions or practices, as they relate to clean claims generation. Supports process for charge capture for global accounts and for research accounts. Completes and/or supports clinical appeals for outpatient services, and may, from time to time, assist in issuing inpatient appeals as well. Perform audits as needed.
Qualifications:
Minimum:
- Bachelor’s degree plus 3 years’ experience in coding/auditing functions OR
- High School diploma plus 7 years’ experience in professional coding/auditing functions.
- Must have current CCS, CCS-P or CPC certification and an understanding of the revenue cycle. Requires a demonstrated ability to present information verbally; strong written communication skills with attention to detail; have demonstrated ability to work with physicians and must be able to work in and manipulate data successfully in EXCEL. Prefer CPMA or CEMC certification.
Preferred:
- BSN, AND, CPC, CCS
- One year of case management, coding, charge capture, auditing, or hospital billing
- Hospital coding knowledge
Additional Information:
Responsibilities:
• Responsible for oversight of the quality hospital billing guidelines and charges posted by operations providing daily and immediate clinical expertise to charge capture activities. Supports and resolves edits discovered by the Revenue Guardian within EPIC. Answers questions from colleagues regarding missing charges or the appropriateness of charges. Completes daily work list of bills holding for charge capture issues. Must meet departmental productivity standards on a regular basis. Responsible for working all assigned Revenue Guardian work queues in EPIC. Evaluate research and determine appropriate charging for accounts assigned to the Nurse Audit Queue within five business days. Work accounts in a thorough and accurate manner and take appropriate action. Work with clinical departments to address missing or complex documentation in a professional manner. Identify charging patterns and notify department and/or management so issues can be resolved. Responsible for working assigned claim edit work queues daily, ensuring that a sufficient number of medical records are addressed for quality in conjunction with compliance
• Provide high level oversight for staff by offering clinical expertise. Work in collaborative effort with leadership, department directors and physicians to enhance and maintain revenue cycle processes to ensure the capture of information required for billing and procuring payment from third parties and patients; responsible for actively monitoring operational and financial performance to identify opportunities for improvement and anticipate and meet the needs of leadership; identifies and drives change in processes that will improve efficiencies and improve core throughput in all revenue cycle related functions.
• Support and/or complete clinical denials, particularly in the outpatient arena and particularly where the authority of a nurse will be beneficial to the success of the appeal. Investigate the reason for the denial, make a determination for the appeal, and provide denials team member’s documentation to support an appeal. Collaborate with staff to complete and resolve billing requirements, which require clinical expertise, including certain Blue Cross bar code letters, Medicaid pharmacy authorizations, and other third-party inquiries, which delay claims adjudication.
• Performs charge audits. Assess, analyze, and arbitrate external audits within the guidelines of the external charge audit policy.
• Perform other duties as assigned.
Salary Information:
Required Documents to Apply:
Optional Documents:
Special Instructions to Applicants:
Recruitment Contact Information:
Please contact [email protected] for any recruiting related questions.
All application materials must be uploaded to the University of Arkansas System Career Site https://uasys.wd5.myworkdayjobs.com/UASYS
Please do not send to listed recruitment contact.
Pre-employment Screening Requirements:
Criminal Background Check
This position is subject to pre-employment screening (criminal background, drug testing, and/or education verification). A criminal conviction or arrest pending adjudication alone shall not disqualify an applicant except as provided by law. Any criminal history will be evaluated in relationship to job responsibilities and business necessity. The information obtained in these reports will be used in a confidential, non-discriminatory manner consistent with state and federal law.
