Under limited supervision, the Physician Billing Compliance Analyst performs physician coding and documentation audits for providers of the University of Florida College of Medicine - Jacksonville and the University of Florida Jacksonville Physicians Group.
The role includes abbreviated reviews of newly hired providers’ documentation outside of the regular compliance audit cycle. Audit focus includes physician and advanced practice professional coding and chart documentation, with review of E&M, CPT, ICD-10-CM, HCPCS Level II, teaching physician guidelines, and carrier-specific policies.
The analyst uses medical management systems and auditing software to complete reviews, prepares and presents audit findings, coordinates refunds when needed, and helps address education needs identified through the audit process.
Key responsibilities include:
- Auditing chart documentation and professional billing for compliance with coding, documentation, and regulatory requirements
- Summarizing audit findings for the central compliance database
- Participating in audit opening and closing conferences
- Identifying training needs and conducting remedial training when needed
- Helping develop policies and procedures for billing compliance
- Supporting special projects and research for the Manager and Director of Physician Billing Compliance
- 2 years of medical billing experience
- 4 years of medical coding experience for procedural and diagnosis coding in a multi-specialty environment
- 3 years of experience with Medicare, Medicaid, and Tricare payment and reimbursement rules
- 3 years of medical record chart auditing experience for professional billing
- 1 year of experience with medical management information systems, EPIC preferred
- 1 year of experience with auditing software applications such as MDaudit or Compliance Risk Analyzer preferred
- High school diploma or GED required
- Associate degree in business or a healthcare-related field preferred
- Certified Coding Specialist (CCS) required at time of hire or by hire
- Certified Coding Specialist - Physician Based (CCS-P) required at time of hire or by hire
- Certified Professional Coder (CPC) required at time of hire or by hire
- Certified Professional Medical Auditor (CPMA) required within 6 months
Location
Jacksonville, Florida, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
4 weeks ago