Fayetteville, AR, USA
18 days ago
Compliance Audit Manager
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Closing Date:

09/30/2024
Type of Position:Management - Operations
Job Type:Regular
Work Shift:Day Shift (United States of America)

Sponsorship Available:

No
Institution Name: University of Arkansas for Medical Sciences


The University of Arkansas for Medical Sciences (UAMS) has a unique combination of education, research, and clinical programs that encourages and supports teamwork and diversity. We champion being a collaborative health care organization, focused on improving patient care and the lives of Arkansans.
 

UAMS offers amazing benefits and perks (available for benefits eligible positions only):

Health: Medical, Dental and Vision plans available for qualifying staff and familyHoliday, Vacation and Sick LeaveEducation discount for staff and dependents (undergraduate only)Retirement: Up to 10% matched contribution from UAMSBasic Life Insurance up to $50,000Career Training and Educational OpportunitiesMerchant DiscountsConcierge prescription delivery on the main campus when using UAMS pharmacy

Below you will find the details for the position including any supplementary documentation and questions you should review before applying for the opening.  To apply for the position, please click the Apply link/button.

The University of Arkansas is an equal opportunity, affirmative action institution. The University does not discriminate in its education programs or activities (including in admission and employment) on the basis of age, race, color, national origin, disability, religion, marital or parental status, protected veteran status, military service, genetic information, or sex (including pregnancy, sexual orientation, and gender identity). Federal law prohibits the University from discriminating on these bases. Questions or concerns about the application of Title IX, which prohibits discrimination on the basis of sex, may be sent to the University's Title IX Coordinator and to the U.S. Department of Education Office for Civil Rights.

Persons must have proof of legal authority to work in the United States on the first day of employment.

All application information is subject to public disclosure under the Arkansas Freedom of Information Act.

At UAMS we value Diversity, Equity and Inclusion.
 

For general application assistance or if you have questions about a job posting, please contact Human Resources at askrecruitment@uams.edu.


Department:INST | Compliance Clinical Billing Comp


Department's Website:


Summary of Job Duties:The Compliance Audit Manager, under the general direction of the Sr. Director of Clinical Billing Compliance, reviews medical records and billing system programs to determine billing accuracy and to ensure that all federal and state guidelines for billing are followed; DRGs, Outpatient APCs, research billing, drug billing, and other identified risk areas. Leads or assists in audits and reviews by outside regulatory agencies. Contributes to the fulfillment of UAMS’ mission and vision by assisting in implementing and maintaining a corporate compliance program, policies and procedures.
Qualifications:

Minimum Qualifications:

Bachelor's degree plus seven (7) years' experience in professional/hospital coding/auditing functions.

Must have one of the following CURRENT coding certifications: Registered Health Information Administrator (RHIA), Certified in Healthcare Compliance (CHC), Certified Professional Coder (CPC), Registered Nurse (RN), Certified Coding Specialist-Physician (CCS-P) or Certified Coding Specialist (CCS).Must have demonstrated ability to present information verbally, and have strong written communication skills with attention to detail.Must have ability to make reasonable decisions based upon the information gathered and ability to make independent audit decisions.

 

Preferred Qualifications:

Knowledge in areas of auditing, communication, problem identification, investigation and resolution, billing/coding, risk management, regulatory compliance or internal auditing. Ability to create PowerPoint presentations and ability to present regulatory information to large groups.Prefer degree in Health Information Management, Healthcare Administration, or related field.


Additional Information:

Additional Information:

Performs audits at the direction of the Senior Director of Clinical Billing Compliance or the Vice Chancellor for Institutional Compliance and on various Medicare regulations and assigned billing risks. Performs ad hoc audits and reviews on areas of compliance concern and regulations governing hospitals. As needed, performs audits and assists in preparation of responses relative to any suspected violations. Attends meetings for Senior Director of Clinical Billing Compliance as requested.  Prepares audit reports for Senior Director of Clinical Billing Compliance’s review as well as dissemination to Hospital Administration and Department Directors. Completes projects in a timely manner.Participates in review of and preparation of response to audits by external agencies (OIG, MAC, OMIG, RAC, etc.). Communicates with regulatory agencies (Novitas Solutions, Arkansas Medicaid, etc.) as necessary for clarification of regulations or for assistance with audit issues or regulatory issues as needed. Participates in the review and analysis of complicated clinical trial protocols.   Responsible for taking clinical trial protocols and developing the budget and coverage analysis to start an audit.   The ability to understand the coding from the protocol, apply Medicare coding rules to Medicare Clinical Trial billing rules and audit the trial for accuracy.  Ability to work at the level to discuss the audit with research coordinators and principal investigators.Keeps abreast of current trends, problems and activities relating to coding. Proficient and keeps current with all coding policies and procedures and applicable federal and state regulations.Participates in special projects as assigned by the Senior Director of Clinical Billing Compliance and/or the Vice Chancellor for Compliance and Managing Associate for General Counsel and other duties as assigned.


Salary Information:

Commensurate with education and experience.


Required Documents to Apply:

List of three Professional References (name, email, business title), Resume


Optional Documents:

Proof of Veteran Status
Special Instructions to Applicants:Must have one of the following CURRENT coding certifications: RHIA, CHC, CPC, RN, CCS-P, or CCS


Recruitment Contact Information:

Please contact askrecruitment@uams.edu for any recruiting related questions.


All application materials must be uploaded to the University of Arkansas System Career Site https://uasys.wd5.myworkdayjobs.com/UASYS  

Please do not send to listed recruitment contact.


Pre-employment Screening Requirements:No Background Check Required


This position is subject to pre-employment screening (criminal background, drug testing, and/or education verification). A criminal conviction or arrest pending adjudication alone shall not disqualify an applicant except as provided by law. Any criminal history will be evaluated in relationship to job responsibilities and business necessity.  The information obtained in these reports will be used in a confidential, non-discriminatory manner consistent with state and federal law. 


Constant Physical Activity:Manipulate items with fingers, including keyboarding, Sitting
Frequent Physical Activity:Hearing, Talking, Walking
Occasional Physical Activity:Crouching, Kneeling, Reaching, Standing, Stooping
Benefits Eligible:Yes
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