Job description
UTHealth Houston is looking for a Billing Compliance Specialist to work with our Institutional Compliance Department. This employee will assist with training efforts for physicians and non-physician providers, on documentation and billing requirements. The ideal candidate should be comfortable with public-speaking and possess effective communication skills. You will lead presentations about billing compliance to healthcare professionals of many different specialties. Applicants must be comfortable in researching different issues to inform these groups. All applicants must have a certification in coding to be considered for this role.
The Billing Compliance Specialist will act as a resource for healthcare billing compliance activities across the university. This employee identifies trends, issues, and risk areas and recommends corrective action. Coordinates and works in collaboration with billing compliance liaisons university-wide with the goal of ensuring documentation is compliant with regulatory requirements.
The employee will perform billing compliance audits for UTHealth Services, School of Dentistry, and our John S. Dunn Behavioral Sciences Center. They will also assist with regulatory billing compliance reviews received from CMS or CMS Contractors. Additionally, they will assist our Chief Compliance Officer, Deputy Compliance Officer, and Healthcare Billing Compliance Manager in responding to reports of suspected noncompliance in these areas. The specialist will also assists in developing and revising billing compliance policies. Compliance audits will need to be conducted for physicians as needed.
This role will be a hybrid position that will come into the office for meetings and presentations. Currently the schedule mandates at least one day in the office per week. You will need to have audit experience and a knowledge of codes and diagnoses. You will be asked to cover all specialties. Your office will in our University Center Tower which has a parking garage attached that employees do pay to access. It is also on both Metro's bus and rail lines, and located closely to TMC parking lots.
What we do here changes the world. UTHealth Houston is Texas’ resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That’s where you come in.
Once you join us you won't want to leave. It’s because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you’d expect from a top healthcare organization (benefits, insurance, etc.), plus:
- 100% paid medical premiums for our full-time employees
- Generous time off (holidays, preventative leave day, both vacation and sick time – all of which equates to around 37-38 days per year)
- The longer you stay, the more vacation you’ll accrue!
- Longevity Pay (Monthly payments after two years of service)
- Build your future with our awesome retirement/pension plan!
We take care of our employees! As a world-renowned institution, our employees’ wellbeing is important to us. We offer work/life services such as...
- Free financial and legal counseling
- Free mental health counseling services
- Gym membership discounts and access to wellness programs
- Other employee discounts including entertainment, car rentals, cell phones, etc.
- Resources for child and elder care
- Plus many more!
Position Key Accountabilities:
- Conducts risk-based audits, special projects, analyzes results, and recommends corrective action.
- Assists departmental compliance efforts in developing policies and procedures, billing compliance risk mitigation strategies, and specialty specific coding education for providers, non-physician practitioner, and residents.
- Provides and presents findings at departmental meetings regarding coding and compliance issues within departments assigned.
- Maintains effective and cooperative communication with the clinical providers, their departmental compliance and administration personnel, and university administration.
- Assists in the delivery, tracking, and expansion of institution-wide education through computer-based training related to coding and compliance.
- Analyzes, prepares, and disseminates information regarding individual provider compliance to those responsible for departmental compliance efforts.
- Acts as a resource for providers, practitioners, residents, and administration for queries related to coding conventions and compliance readiness.
- Maintains knowledge of current regulatory requirements, coding, and diagnostic procedures.
- Assists in the development and maintenance of departmental tracking systems for audit results (MDaudit), coding questions and employee MDaudit training.
- Performs other duties as assigned.
Certification/Skills:
- Certified Professional Coder (CPC) American Academy of Professional Coders (AAPC), or
- Certified Coding Specialist - Physician-based (CCS-P) American Health Information Management Association (AHIMA)
Minimum Education:
Bachelor’s degree or equivalent related experience in lieu of education.
Minimum Experience:
Two (2) years of multiple-specialty coding and compliance auditing experience; Three (3) years preferred.
Physical Requirements:
Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.
Security Sensitive:
This job class may contain positions that are security sensitive and thereby subject to the provisions of Texas Education Code § 51.215
Residency Requirement:
Employees must permanently reside and work in the State of Texas. This role will be a hybrid position that will come in the office now and then, and offer in-person support.
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