Senior Billing and Coding Compliance Analyst & Educator
Reporting to the UVA Health Compliance and Privacy Office Billing and Coding Manager, the Sr Billing and Coding Compliance Analyst and Educator is responsible for working to ensure that UVA Health and UVA Community Health complies with the laws and regulations governing Federal healthcare programs (e.g., Medicare, Medicaid).
This position is responsible for managing and/or conducting UVA Healths professional and facility billing and coding investigations and reviews across the UVA Health system and conducting post-review education for UVA Health billing providers and departments. The position monitors and collaborates with compliance and operational staff across UVA Health entities (e.g., UVA Medical Center, UVA Community Health, UPG), UVA Health Revenue Cycle, and any external vendors hired to conduct compliance reviews relating to billing investigations or compliance work plans.- Works to prepare the annual risk assessment and compliance work plan.
- Conducts billing and coding-related investigations at all UVA Health and UVA Community Health entities.
- Conducts and/or manages billing and coding reviews conducted pursuant to the Compliance and Privacy Offices compliance work plan.
- Designs and performs billing and coding-related education and training.
- Collaborates with regulatory/compliance functions and staff throughout UVA Health to ensure that the compliance risk assessment captures operational risks and that mitigation plans are created and implemented as necessary.
- Manages (as applicable) billing and coding related reviews conducted by external vendors/auditors.
- Provides oversight and guidance to the development of policies and procedures surrounding documentation, charge capture, coding, and charge entry to ensure compliance with government and payer requirements and to ensure optimization of clinician revenue.
- Works with UVA Health departments to ensure timely refunds of any overpayments to Federal program payors.
- Prepares reports for the entity compliance steering committees, and recommends improvements / solutions, guidance, and remedies.
- Works in cooperation with the executive staff, physicians, and clinical department management to enhance billing quality in a manner that will ensure compliance with government regulations, payer requirements and optimize revenue for the clinical practice.
- Completes other projects and duties as assigned by Director and the Chief Corporate Compliance and Privacy Officer.
MINIMUM REQUIREMENTS
Education: Bachelors degree required.
Experience: 5+ years of relevant professional experience required. Licensure: Certified Professional Coder (CPC), AAPC or Certified Coding Specialist (CCS), AHIMA, required. Other similar coding certifications may be considered. PHYSICAL DEMANDS This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally require traveling some distance to attend meetings, and programs. The starting base rate for this role is $100,000.00 annually. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.Benefits Comprehensive Benefits Package: Medical, Dental, and Vision Insurance Paid Time Off, Long-term and Short-term Disability, Retirement Savings Health Saving Plans, and Flexible Spending Accounts Certification and education support Generous Paid Time Off
UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report Best Hospitals guide rates UVA Health University Medical Center as High Performing in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Childrens is named by 2023-2024 U.S. News & World Report as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond. The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVAs commitment to non-discrimination and equal opportunity employment.
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