UofL Physicians

  • Supervisor, Professional Audit Staff

    Job Locations US-KY-Louisville
    Job ID
    2018-6936
    # of Openings
    1
    Category
    Billling/Collections
  • Overview

    JOB SUMMARY

    The team member performs highly technical and specialized functions.  The Audit Supervisor handles the day-to-day operations of the Compliance Audit Department – including personnel issues, process flows, and audit deadlines. This position requires above average analytical skills, excellent verbal and written communication skills, problem-solving skills, self-motivation, and the ability to make decisions using available data. The audit function is a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, risk trending and educational opportunities. The audit function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines.

    Responsibilities

    JOB RESPONSIBILITIES

    Essential Functions:

    • Supervisor (55% Weight)
      • Work to maintain complex audit processes for physicians, non-physician practitioners, coders and coding supervisors.
      • Support audit staff in accordance with established auditing processes established and assist in making recommendations for improvement to the AVP Compliance.
      • Work in conjunction with AVP, Compliance to establish patterns or trends that require additional training or corrective action
      • Assist with incorporating audit findings into training programs
      • Assist with development of policy and procedures in relation to audit processes
      • Assist with revisions to Policy and Procedure and/or work process development based on audit finding

     

     

    • Compliance (30% Weight)
      • Ensure that documentation meets the Teaching Physician Rules as mandated by CMS and ULP policies prior to release of a code for billing
      • Ensure that documentation for Advanced Practice Providers meets the payer specific rules prior to release of a code for billing
    •  Communication/Education (15% Weight)
      • Develop daily/weekly communication with providers. 
      • Provide comments/suggestions relative to weak areas identified in the coding reviews.
      • Provide trending deficiencies to CBO Supervisor as appropriate.
      • Responds in a timely manner to questions from providers, department representatives.
    • Maintain compliance with rules and regulations regarding coding.
    • Review auditor metrics to ensure standards and expectations are met for best audit practice.
    • Ability to work within a team environment and meet monthly goals.
    • Other duties as assigned.

    Qualifications

    MINIMUM EDUCATION & EXPERIENCE

    • Position requires 7-10 years of coding experience and a minimum of 2 years in a supervisory role. Certified Professional Coder, Certified Processional Medical Auditor designation required.
    • High School education or GED required, related degree preferred.
    • Must have and maintain Certified Professional Coder (CPC) certification through AAPC or must have and maintain CCA, CCS or CCS-P certification through AHIMA. Must have and maintain CPMA through AAPC.
    • Three years direct coding experience and in depth Coding and HIPAA regulations for physician offices, preferred.

    KNOWLEDGE, SKILLS, & ABILITIES

    • Ongoing coding guideline knowledge is required
    • Advance knowledge of medical terminology, abbreviations, techniques and surgical procedures
    • Advance knowledge of medical codes involving selections of most accurate and description code using the ICD-9-CM, ICD-10-CM, CPT, HCPCS, and IHS coding conventions.
    • Advance knowledge of medical codes involving selection of most accurate and descriptive code using the CPT codes for billing of third party resources
    • Skill in correlating generalized observations/symptoms (vital signs, lab results, medications, etc.) to a stated diagnosis to assign the correct ICD-10-CM code
    • Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes.
    • Requires the knowledge of the business use of computer hardware and software to ensure the effectiveness and quality of the processing and presentation of data
    • Strict compliance with all coding guidelines at all times.
    • Working in a highly accurate and yet efficient manner.
    • Strict attention to detail in both coding and EMR entries.

    WORKING CONDITIONS

    • Sedentary Work: Lifting 10lbs. maximum and occasionally lifting and/or carrying items as needed.
    • Frequent Talking (Expressing or exchanging ideas by means of the spoken word.)
    • Frequent Hearing (Perceiving the nature of the sounds by the ear.)
    • Frequent Seeing (Visual acuity, depth perception, field of vision, color vision).
    • Consistent use of hand movement for keyboarding purposes.
    • Concentration varies depending on the tasks at hand. High levels of mental concentration are required.  Must handle multiple tasks simultaneously and is subject to interruptions.  Physical effort requires sitting and reaching with hands and arms.  Manual dexterity, visual acuity, and the ability to speak and hear are required

    HOW TO APPLY

    • Please follow the URL link to submit your resume:
    • Only those candidates whose experience best meets our requirements will be contacted.
    • University of Louisville Physicians is an Equal Opportunity Employer.
    • Current UofL Physicians employees must follow the UofL Physicians Internal Transfer Policy.

     

     

     

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