As a UW
employee, you have a unique opportunity to change lives on our campuses, in our
state and around the world. UW employees offer their boundless energy, creative
problem solving skills and dedication to build stronger minds and a healthier
UW faculty and staff also enjoy outstanding
benefits, professional growth opportunities and unique resources in an
environment noted for diversity, intellectual excitement, artistic pursuits and
natural beauty. All of which has allowed the UW to be nationally recognized as
a “Great College to Work For” for five consecutive years.
UW Medicine Compliance has an outstanding
opportunity for a Facility Billing Compliance Analyst.
UW Medicine Compliance Analysts are responsible
for performing daily activities required to fulfill the goals, audit plans,
work plans, initiatives, and duties related to a specific Compliance program
element or content area. Analysts conduct audits and/or analyze data,
prepare reports pursuant to the unit’s audit plan, and participate in the
development and implementation of follow-up education, outreach, and/or other
corrective actions. Analysts contribute to compliance program development by
maintaining data for unit reports, participating in the development and/or
delivery of educational and outreach materials, and maintaining unit
records. Analysts maintain current knowledge of applicable laws and
regulations and may contribute to the unit’s risk assessments and risk
The Facility Billing Compliance Analyst is
responsible for audits that assess the accuracy of documentation, coding, and
billing against federal regulations (Medicare) and other laws and state laws
and regulations that may apply.
The Facility Billing Compliance Analyst
collaborates with clinical and administrative staff throughout the enterprise
in order to address and mitigate compliance risks. Compliance Analysts
also function as part of a unit team to accomplish unit goals, and work
cooperatively with other compliance staff and entity staff as needed to resolve
shared issues and concerns. In addition, they may participate in committees,
workgroups, or process improvement projects as assigned.
Under general direction, analyze data, draft preliminary audit reports,
and process final reports according to established protocol.
Provide feedback and education on the results of audits and
collaboratively establish corrective action plans.
Review claims denials to assess coding and medical necessity
Research documentation, coding, billing, EMTALA and other related regulatory
Review medical records for compliance with various EMTALA requirements;
assist with the performance of on-site EMTALA audits.
Under general supervision, may review clinical research billing and / or
EMTALA inquiries and complaints or facilitate implementation of corrective
Recommend clinical research billing and / or EMTALA process adjustments
and improvements to leadership.
Investigate billing and coding issues as related to inquiries,
complaints, or audit results.
Serve as a resource for current documentation, coding, billing and
related regulatory guidelines. Develop and maintain detailed audit records,
prepare accurate and timely reports, and generate statistical information as
· Provide information to management for
regularly scheduled reports and updates regarding audit progress and
Exercise sound judgment in the interpretation and application of law,
regulations, policies and procedures.
Safeguard the confidentiality of sensitive information.
Perform other related duties as assigned or required.
- Consistently delivers on commitments and promises;
- Sets own standards of excellence instead of waiting for
standards to be imposed;
- Accepts responsibility for outcomes (positive or negative) of
one’s judgments or actions; admits mistakes and refocuses efforts when
- “Owns” organizational and higher level leadership
Exercising Good Judgment
- Follows established guidelines and policies when making
decisions and demonstrates sound judgment in making decisions when there is no
- Demonstrates technical/professional mastery of skills and
knowledge required for the position.
- Considers problems from all perspectives, and thoughtfully and
responsibly considers all relevant impacts and implications before making a
- Makes effective and timely decisions, even when data are limited
and without unnecessarily referring to others;
- Recognizes who needs to be involved in decisions and engages
them when appropriate.
- Demonstrates a sincere, positive attitude toward helping others
and getting things done; doesn’t say “it’s not my job.”
- Develops and promotes positive working relationships with
- Seeks out, listens to, and considers the ideas and opinions of
- Works cooperatively with others to develop and implement
programs and ideas;
- Shares information and expertise with others to accomplish
- Understands the impact of actions/decisions on other
Bachelor’s degree in a Health Sciences discipline, Business
administration, or related field AND at least five years experience with
hospital billing and coding operations or compliance.
Professional Certifications: CPC, COC, CCS, CCS-P, RHIT, RHIA.
Hospital billing and coding operations or compliance.
Coding, documentation and reimbursement content area expertise in one or
more of the following: utilization management, medical necessity,
inpatient coding, or outpatient coding.
Extensive knowledge of ICD-10-PCS, ICD-10-CM, CPT and HCPCS coding
principles and guidelines.
Comprehensive knowledge of federal and state regulations related to
documentation, coding and billing.
Proficiency with MS Word and Excel.
Excellent oral and written communication skills.
Self-motivated, detail-oriented and highly organized skill set.
Equivalent education/experience will substitute for all minimum
qualifications except where there are legal requirements such as
Inpatient (billing/coding/documentation) experience.
Experience in an academic healthcare environment.
Proficiency with electronic medical records systems, databases, and
related automated systems.
Clinical experience including but not limited to LPN or RN
Certified in Healthcare Compliance (e.g. HCCA/HCCB CHC
· Experience with