[Hiring] Healthcare Compliance Audit Analyst @U.S. Urology Partners

Role Description

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.

• Conduct physician/provider and facility documentation audits.
• Ensure accuracy of data entered into the CD Internal Audit Database and prepare reports for audited providers, department leadership, and organization leadership.
• Analyze audit data and provide summary feedback to clinic and billing staff, making recommendations for improvement.
• Work with the billing and coding departments to determine charge corrections and refunds resulting from compliance audits.
• Collaborate closely with the billing department to minimize denial issues for appropriate reimbursements.
• Receive and respond to audit, documentation, and coding review requests from the billing department.
• Perform research for various billing and coding scenarios.
• Provide input in the development and improvement of procedures used to complete the audit function.
• Assist in conducting formal/informal education sessions for educating and training physicians, non-physician providers, and other staff.
• Identify additional opportunities to improve education of physicians, non-physician providers, and staff.
• Prepare and produce billing/coding/documentation communication for guidance documents, website content, newsletter content, education content, and other communication channels.
• Develop materials for education and communication derived from audit findings for feedback to physicians, department billing staff, and other compliance staff.
• Identify education/awareness opportunities and guidance topics based on types of questions/issues received.

Qualifications

• Experience with using and navigating through an electronic medical record system.
• Knowledge of state, federal, local, and payer-specific regulations and policies pertaining to documentation, coding, and billing.
• Demonstrated capacity to work independently in an organized, detailed manner while maintaining a collaborative team environment.
• Ability to think abstractly and concretely.
• Ability to develop reports, presentations, and spreadsheets.
• Strong computer skills including effective use of Microsoft Word, Excel, Outlook, PowerPoint, Access, and Internet Explorer.
• Outstanding verbal and written communication skills.
• Experience in handling complex organizational projects and excellent problem identification and solution skills.
• Ability to gain the trust and confidence of providers, compliance team, and billing staff.

Requirements

• Bachelor's degree in health administration, health information management, or another related field preferred.
• CPC, CCS-P, or CPMA required.
• Minimum of three years of experience in healthcare compliance, healthcare operations, coding, and/or documentation auditing in a healthcare organization preferred.

Benefits

• Comprehensive medical, dental, and vision plans.
• HSA / FSA.
• 401(k) matching.
• Employee Assistance Program (EAP).
• Beyond competitive compensation.

Company Description

U.S. Urology Partners is one of the nation’s largest independent providers of urology and related specialty services, including general urology, surgical procedures, advanced cancer treatment, and other ancillary services.

• Clinical network consists of more than 50 offices throughout the East Coast and Midwest.
• Includes a state-of-the-art, urology-specific ambulatory surgery center that is one of the first in the country to offer robotic surgery.
• Formed to support urology practices through an experienced team of healthcare executives and resources.