University of Utah Job Description
Job Summary
Provides compliance related coding reviews and auditing of faculty and physician documentation. The position will utilize coding knowledge to abstract, record and audit data from medical records. Provides support to areas related to documentation, regulatory education and auditing.
Qualifications
Bachelor’s degree in Health Care Administration, Business Administration or a related field or equivalency (one year of education can be substituted for two years of related work experience); plus 2 years working experience with one of those years working in a compliance office. American Health Information Management (AHIMA) or American Academy of Professional Coders (AAPC) recognized certification such as: Certified Professional Coder (CPC), Certified Professional Coder-Hospital (CPC-H) or a specific certification preferred by the Department.
Basic knowledge of clinical documentation requirements related to regulatory and reimbursement rules, the Medicare system and proficiency with computer software such as Microsoft Word and Excel; demonstrated human relations and effective communication skills also required.
Experience with University of Utah computer systems is highly preferred.
This position is not responsible for providing patient care.
Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.
Disclaimer
This job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.
Essential Functions
1. Locates and compiles required medical documentation from a variety of different sources, ensuring completeness and accuracy in preparation for pre-audit meetings.
2. Audits and reviews UBs and 1500s against provider and facility documentation to ensure compliance with University, state and federal guidelines.
3. Reconciles clinic or provider visits and reports to the assigned Compliance Officer missing, incomplete or inconsistent documentation.
4. Interacts with and provides auditing feedback to providers, hospital staff and clinic managers on billing related issues.
5. Researches, maintains current knowledge, and interprets state and federal regulations regarding payments in health care to audit claims correctly.
Problem Solving
The incumbent may be required to prioritize tasks from multiple Compliance Officers and determine the order of importance. Incumbent will coordinate work processes with co-workers, supervisors and department leadership in the resolution of complex government and regulatory issues. Must be able to understand objectives and policies governing the activities of the department in order to effectively communicate necessary information to interested parties.
Comments
Work Environment and Level of Frequency typically required
Nearly Continuously: Office environment.
Physical Requirements and Level of Frequency that may be required
Nearly Continuously: Sitting, hearing, listening, talking.
Often: Repetitive hand motion (such as typing), walking.
Seldom: Bending, reaching overhead.
