Compliance Analyst (Remote) - Billing Compliance and Audit

Scheduled Hours 40 Position Summary Position is responsible for conducting comprehensive and focused audits in a variety of WashU Medicine multi-disciplinary clinical practices. The purpose of the audits is to determine accuracy of coding, documentation, and physician/provider compliance with CPT and ICD-9-CM coding standards, governmental billing regulations, and University policy. The position is responsible for analysis and interpretation of audit data resulting in communication of audit findings through written report. Job Description Primary Duties & Responsibilities: • Perform audit function of the WashU Medicine Office of Physician Billing Compliance (OPBC). • Follow audit plan/schedule as outlined in the OPBC fiscal year work plan as approved by the Compliance Director. • Identify and select audit sample via Epic billing system query and secure selected medical records from inpatient and outpatient locations. • Review medical record documentation for compliance with CPT and ICD-10-CM coding standards, University policy and Center for Medicare and Medicaid Services (CMS) regulations, including regulation applicable to physicians in teaching hospitals. • Analyze and interpret the data collected. • Research issues that arise out of audit findings. • Prepare reports, as required, to provide an analysis of the data collected and to inform physicians, departmental staff and/or compliance personnel of findings. • Report issues of non-compliance identified through the audit process to the Compliance Audit Manager. • Create and/or modify all auditing tools and aids to ensure compliance, including modifications necessary to reflect changes in regulations as they occur. • Research specialty specific coding/billing issues prior to departmental/divisional audits and keep abreast of current specialty-specific coding literature and changes in regulation, standard coding practice and policy. • Notify Compliance Educator(s) of department/division specific practices, policies and procedures that may affect and/or raise compliance issues identified during the audit process. • Ensure audit protocol adheres to the Standards of Ethical Coding as set forth by the American Health Information Management Association and to official coding guidelines. • Perform special audit and compliance-related projects as assigned. Working Conditions: Job Location/Working Conditions: • Normal office environment. Physical Effort: • Typically sitting at desk or table. • Occasional lifting (25 - 50 lbs). Equipment: • Office equipment. The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all job duties performed by the personnel so classified. Management reserves the right to revise or amend duties at any time. Required Qualifications Education: Associate degree or combination of education and experience may substitute for minimum education. Certifications: No specific certification is required for this position. Work Experience: No specific work experience is required for this position. Skills: Health Care Driver's License: A driver's license is not required for this position. More About This Job WashU seeks highly motivated individuals who are able to perform duties in a manner consistent with our core mission and guiding principles. Preferred Qualifications Education: Bachelor's degree Certifications: Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC), Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA), Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA), Registered Nurse - Illinois Department of Financial and Professional Regulation, Registered Nurse - Missouri Division of Professional Registration Work Experience: No additional work experience unless stated elsewhere in the job posting. Skills: Clinical Experience, CMS Regulations, Communication, Computer Applications, Continuous Quality Improvement (CQI), Current Procedural Terminology (CPT), HIPAA Regulations, ICD-10 Procedure Coding System, Medical Record Reviews, Spreadsheets, Teamwork, Word Proccessing, Working Independently Grade C13 Salary Range $68,100.00 - $105,500.00 / Annually The salary range reflects base salaries paid for positions in a given job grade across the University. Individual rates within the range will be determined by factors including one's qualifications and performance, equity with others in the department, market rates for positions within the same grade and department budget. Questions For frequently asked questions about the application process, please refer to our External Applicant FAQ. Accommodation If you are unable to use our online application system and would like an accommodation, please email [email protected] or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request. All qualified individuals must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship. Pre-Employment Screening All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening. Benefits Statement Personal • Up to 22 days of vacation, 10 recognized holidays, and sick time. • Competitive health insurance packages with priority appointments and lower copays/coinsurance. • Take advantage of our free Metro transit U-Pass for eligible employees. • WashU provides eligible employees with a defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions and university contributions starting at 7%. Wellness • Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more! Family • We offer 4 weeks of caregiver leave to bond with your new child. Family care resources are also available for your continued childcare needs. Need adult care? We've got you covered. • WashU covers the cost of tuition for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us. For policies, detailed benefits, and eligibility, please visit: EEO Statement Washington University in St. Louis is committed to the principles and practices of equal employment opportunity and especially encourages applications by those from underrepresented groups. It is the University's policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity, color, national origin, age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information. Washington University is dedicated to building a community of individuals who are committed to contributing to an inclusive environment - fostering respect for all and welcoming individuals from diverse backgrounds, experiences and perspectives. Individuals with a commitment to these values are encouraged to apply. Apply tot his job