University of Mississippi Medical Center
Introduction:
To oversee and perform internal audits to ensure regulatory compliance in an assigned area such as documentation, coding, and billing.
Job Description:
- Performs audits on assigned areas or units and reports results to appropriate personnel.
- Participates in the development of educational and training programs that focus on elements of the compliance program; explains compliance program guidelines, policies, and procedures to departmental staff and physicians.
- Analyzes operating procedures, identifies potential violations, and provides technical assistance/recommendations to management.
- Collaborates with managers to identify aberrant trends in coding, billing, documentation and other compliance areas.
- Confers with external auditors to ensure compliance of an assigned area.
Required Qualifications:
Bachelor’s degree in accounting, health information management, business administration, health or social sciences, or related field plus three (3) years of ICD-9/ICD-10 coding, CPT coding, and/or billing experience or equivalent combination of education/experience.
Preferred Qualifications:
Prefer certification from American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), or Health Care Compliance Association (HCCA).
Education Qualifications:
Knowledge of CPT and ICD-10 coding principles and guidelines, medical terminology, and insurance plans. Verbal and written communication skills. Interpersonal skills to effectively interact with clients and other compliance staff members. Skill in applying regulatory guidelines to identify and solve problems. Skill in conducting compliance training. Ability to gather and analyze medical records and billing data and generate reports. Ability to present educational information.