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PROFESSIONAL BILLING COMPLIANCE ANALYST

University of Washington
Seattle, WA Full-time
Posted on February 8, 2020
Req #: 175778
Department: SCHOOL OF MEDICINE
Posting Date: 01/08/2020 
Closing Info: Open Until Filled 
Salary: Salary is commensurate with qualifications and experience.  
Shift: First Shift 
Notes: As a UW employee, you will enjoy generous benefits and work/life programs. 
For detailed information on Benefits for this position, click here.
 

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 world.

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 six consecutive years.

UW Medicine has an outstanding opportunity for a Professional Billing Compliance Analyst.

In general, 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.  All Analysts maintain a skill set tailored to their respective content area in order to research and analyze unit-specific issues and concerns, including complaints.  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 mitigation strategies.

All Compliance Analysts 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.

The Professional 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.

Reporting to the Billing Compliance Manager, Analysts for the Billing Compliance Unit conduct daily activities pursuant to the unit’s goals, audit plan, and work plan.  Analysts in the unit have regular interaction with clinic managers, revenue cycle staff, and Patient Financial Services staff.

Specific Duties and Responsibilities
  • Perform audits, analyze results, and write audit reports
  • Provide feedback and education on the results of audits and collaboratively establish corrective action plans
  • Review claims denials to assess coding and medical necessity issues
  • 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


    COMPETENCIES

    Accountability
  • 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 appropriate;
  • “Owns” organizational and higher level leadership decisions.

    Exercising Good Judgment
  • Follows established guidelines and policies when making decisions and demonstrates sound judgment in making decisions when there is no precedent/guideline.

    Job Knowledge
  • Demonstrates technical/professional mastery of skills and knowledge required for the position.

    Problem Solving
  • Considers problems from all perspectives, and thoughtfully and responsibly considers all relevant impacts and implications before making a decision;
  • 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.

    Service Orientation
  • Demonstrates a sincere, positive attitude toward helping others and getting things done; doesn’t say “it’s not my job.”

    Teamwork
  • Develops and promotes positive working relationships with colleagues;
  • Seeks out, listens to, and considers the ideas and opinions of others;
  • Works cooperatively with others to develop and implement programs and ideas;
  • Shares information and expertise with others to accomplish mutual goals;
  • Understands the impact of actions/decisions on other individuals/departments/stakeholders.


    MINIMUM REQUIREMENTS
    Bachelor’s degree in a Health Sciences discipline, Business administration, or related field. Minimum of five years experience with healthcare billing and coding operations or compliance.

    Additional Requirements:
  • Coding, documentation and reimbursement content area expertise in one or more of the following:  utilization management, medical necessity, inpatient coding, or outpatient coding.
  • Current coding certification, particularly RHIT, CCS and/or CPC.
  • Expert knowledge of healthcare billing and coding (specifically ICD-9-CM, ICD-10-CM, CPT and HCPCS coding principles and guidelines) to provide support services to providers and entity coding staff; and to be effective in daily audit duties.
  • Comprehensive knowledge of federal and state regulations related to documentation, coding and billing.
  • Proficiency with Microsoft products.
  • Demonstrated ability to analyze and distill complex audits and make recommendations, both verbal and in writing, based on findings.
  • Effectively communicate and present subject matter material to providers sufficient to advance their comprehension of compliance regulations.
  • 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 license/certification/registration.

    DESIRED REQUIREMENTS
  • Experience in an academic healthcare environment.
  • Proficiency with electronic medical records systems, databases, and related automated systems.
  • Clinical experience.
  • Certified in Healthcare Compliance (e.g. HCCA/HCCB CHC certificate).

    CONDITION OF EMPLOYMENT
    UW Medicine Compliance manages a significant volume of audits, inquiries and consultations.  Work priorities shift in response to fluctuating demands.  Full time schedules are assumed to be at least 40 hours, however, incumbents are expected to remain flexible to accommodate the unit's goals and mission, and to work beyond their normal schedule when necessary.

    Application Process:
    The application process for UW positions may include completion of a variety of online assessments to obtain additional information that will be used in the evaluation process. These assessments may include Work Authorization, Cover Letter and/or others. Any assessments that you need to complete will appear on your screen as soon as you select “Apply to this position”. Once you begin an assessment, it must be completed at that time; if you do not complete the assessment you will be prompted to do so the next time you access your “My Jobs” page. If you select to take it later, it will appear on your "My Jobs" page to take when you are ready. Please note that your application will not be reviewed, and you will not be considered for this position until all required assessments have been completed.

  • Committed to attracting and retaining a diverse staff, the University of Washington will honor your experiences, perspectives and unique identity. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable and welcoming.

    The University of Washington is a leader in environmental stewardship & sustainability, and committed to becoming climate neutral.

    The University of Washington is an equal opportunity, affirmative action employer. To request disability accommodation in the application process, contact the Disability Services Office at 206-543-6450 / 206-543-6452 (tty) or dso@uw.edu.