|Employer:||Washington University School of Medicine
|Required Certifications:||CPC or RHIT or CPMA
|Required Experience:||3 to 4 years
|Preferred Experience:||5 to 7 years
|Location:|| St. Louis 63130, MO, US
POSITION SUMMARY: The Coordinator, Billing Compliance is responsible for providing support to Washington University Clinical Associate (WUCA) practices with regard to billing and coding compliance: ensures preliminary audits of new WUCA practices occur within 3 months of hire, performs routine audits of all existing WUCA practices to complement WUSM Office of Professional Billing Compliance (OPBC) formal audit schedule, assists with implementation of OPBC recommendations and monitors for compliance, counsels physicians and practice staff on new coding regulations, provides resources for billing compliance training, provides guidelines for billing for midlevel providers as needed, provides recommendations on how to maximize billing opportunities, shares best practices with WUCA practices, acts as overall resource for coding and documentation questions.
PRIMARY DUTIES AND RESPONSIBILITIES (Essential Functions)
• Responsible for ensuring that all WUCA providers are audited, at a minimum once a year, with new providers audited within 3 months of hire. Maintains documentation of audit schedule and prepares reports for senior leadership as needed. Prepares quarterly reports on audit findings, high risk trends and implementation of corrective actions.
• Follows up on OPBC audits within required timeframe: meets with physicians and practice staff, addresses questions, researches findings, and prepares required follow-up reports in collaboration with physicians and WUCA management. Works with practices to implement specific audit recommendations as needed. Shares best practices across practices.
• Coordinates access to necessary records and documents required during the audit process.
• Assists with development of policies and procedures to facilitate compliant documentation and coding in EPIC.
• Acts as a resource to WUCA practices and physicians for billing and coding questions, education of new regulations, compliance inquiries, coding trends, documentation for midlevel providers etc.
• Coordinates access to additional resources in OPBC, PBS, WUPN, HIPAA, HIRS and FPP to support WUCA practices.
• Participates as member of WUCA support team in onboarding of new WUCA practices as needed.
Required qualifications include cachelor’s degree in related field with minimum of 5 years of experience, billing compliance auditing, and certification in one of the following: Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), or equivalent related certification. Must have knowledge of CMS documentation and billing regulations. Requires knowledge of ICD-10 and CPT coding.
Preferred qualifications include experience with EPIC medical record and revenue cycle/billing.
Candidates will have experience in medical record review for documentation and/or utilization review and excellent communication skills and the ability to work independently. Knowledge of eClinical Works