Washington University is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity or expression, national origin, genetic information, disability, or protected veteran status.
This position is full-time and works approximately 40 hours per week.
Department Name/Job Location:
This position is in the Department of Neurology. The position is located at Mid Campus Center. This position is for the Medical School Campus.
The Compliance Review and Claims Analyst is responsible for overseeing all aspects of the Department of Neurology’s medical coding & compliance programs. Position is also responsible for ensuring compliance with federal & state regulations, third party requirements and WUSM policies as they relate to professional fee billing & HIPAA.
PRIMARY DUTIES AND RESPONSIBILITIES:
Ensure the Department of Neurology’s coding protocols adheres to standards consistent with official CPT procedural and ICD-10-CM diagnosis coding standards, University policy and government & third party regulations. Keep abreast of changes to CPT and ICD-10-CM. Organize, interpret, condense and disseminate changes and procedures to the appropriate supervisors, staff, physicians and physician staff in a timely manner.
Schedule & perform medical chart audits for correct coding and compliance with governmental and third party regulations. Provide feedback to practitioners regarding audit results and education on proper coding techniques and/or compliance regulations. Provide education to new providers and residents on proper documentation & billing compliance.
Monitor physician note completion and provide reports to providers on regular basis.
Ensure all eligible employees in the department complete their annual billing compliance training. Serve as a liaison with School of Medicine’s Office of Physician Billing & Compliance. Assist with development of ICD-10 and serve as university contact for ICD-10 sub-committee. Maintain up-to date coding and compliance files on each practitioner.
Assist clinical services staff with policy interpretation, coding questions, and appeal letters as needed.
Assist with investigating & pursuing new billing opportunities specific to neurological sciences.
Perform miscellaneous duties as assigned.
Associate degree with three years of experience in a health-related field or combined education and experience in a health-related field of five years.
Bachelor’s degree (four year college or technical school) – preferred field of study: business, accounting, public health, or similar.
Current RHIT/RHIA certification, or CPC/CCS-P certification.
Three to five years of related experience in areas, such as medical coding, physician billing auditing, and/or physician billing and compliance.
Healthcare experience with working knowledge of accounts receivable/healthcare revenue cycle.
Good working knowledge of EPIC or other electronic health records.
Strong knowledge base in complete and accurate clinical documentation.
Strong knowledge of federal and state healthcare regulations, standards, policies and requirements pertaining to documentation, coding and billing.
Ability to accurately interpret and implement regulatory standards and legal requirements.
PC software knowledge, including Microsoft Office applications.
Developed office skills, including use of variety of data systems, general office equipment, effective telephone, interpersonal and communication skills.
Ability to communicate effectively with healthcare practitioners and co-workers.
Experience in ICD-10 and CPT coding.
Knowledge, skills and disciplines essential to the performance of physician compliance reviews of healthcare institutions.
Ability to prepare written reports and correspondence.
Ability to be flexible.
Ability to handle multiple priorities.
Ability to adjust to high pressure and rapidly changing business conditions.
The hiring range for this position is $56,472 - $72,010 annually.
All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. Current employees applying for a new position within the university may be subject to this requirement. The screenings will include a criminal background check and, as applicable for the position, other background checks, drug screen, employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening.
Please attach a copy of your most current signed performance evaluation (completed within the last 18 months) to your online account. If you have not received a performance evaluation, you may provide two current signed letters of recommendation (written within the last 18 months), preferably to include one letter from either a current or recent former supervisor. To attach these documents, go to: My Career Tools, Add Attachment, Attachment Type – Performance Reviews or Letters of Recommendation.
Washington University in St. Louis, a medium-sized, independent university, is dedicated to challenging its faculty and students alike to seek new knowledge and greater understanding of an ever-changing, multicultural world. The University offers more than 90 programs and almost 1,500 courses leading to bachelor's, master's and doctoral degrees in a broad spectrum of traditional and interdisciplinary fields, with additional opportunities for minor concentrations and individualized programs. The faculty is composed of scholars, scientists, artists and members of the learned professions. They serve society by teaching; by adding to the store of human art, creativity, understanding, and wisdom; and by providing direct services, such as health care.