We are seeking a Sr. Compliance Auditor Trainer who will provide on-going training and support to physicians, non-physician providers, professional fee billing staff, clinic staff, administrators, and other affected personnel on documentation and billing requirements. Using auditing and analysis techniques, determines the adequacy of medical records documentation, coding and billing for all providers across all clinical specialties. Works in close collaboration with the clinical departments, Physicians Billing Service, and the Johns Hopkins Health System Compliance Office. The documentation audits are conducted as part of the School of Medicine?s Quality Assurance Compliance Program. Prepares reports for the Senior Director, Director, and clinical departments regarding the status or results of the reviews. Summary results are presented to the Clinical Practice Association?s Board of Governors, the University?s Trustee Committee for Audits and Insurance and other appropriate offices within the School of Medicine or Johns Hopkins Medicine.

Specific Duties & Responsibilities

• Conducts independent reviews/audits on the adequacy of medical record documentation to support the codes selected by providers or by billing office coders.
• Verifies and corrects as necessary, the audit work completed by the Compliance Auditors or other Sr. Auditors/Trainers.
• Analyzes documentation or coding patterns by a provider, division or department that poses a compliance risk and recommends solutions to address the problem(s).
• Assists departments and providers in developing corrective action plans to improve documentation practices, address compliance problems, or improve professional fee billing  activities.
• Conducts training sessions for providers, professional fee billing staff and others on a regularly scheduled or ad hoc basis.
• Provides feedback to providers on the results of their medical record documentation reviews and gives targeted training as needed.
• Research and answers billing and documentation questions or problems submitted by faculty, departments, billing staff, and others to ensure compliance with specific payer regulations and School of Medicine / Clinical Practice Association policies and procedures.
• Regularly monitors potential billing problems and/or billing errors identified by each departments? professional fee billing office.
• Prepares and revises as needed a Compliance Training Manual for routine and special training programs.
•  Assists in the development of medical record documentation standards and requirements related to clinical services billing.
•  Keeps current with third party regulations with emphasis on Medicare billing, teaching physician regulations, Current Procedural Terminology, ICD-9-CM Coding, and professional fee billing.
• Performs other compliance related activities as necessary.
• May be asked to assist with training new staff or correcting the work of others. Identifies and suggests process and operational improvement.
  

• On a regular and continual basis, exercises administrative judgment and assumes responsibility for decisions, consequences, and results having an impact on people, costs, and/or equality of service within the functional area. Routinely handles confidential patient information and sensitive financial information.
  

• Knows the formal and informal departmental goals, standards, policies and procedures which include familiarity of other departments within the school/division. Is sensitive to the relationship of both people and functions within the department, the Clinical Practice Association and JHHS Compliance Office.
  
• Exchanges non-routine information using tact and persuasion as appropriate requiring good oral and written communication skills.
  

Special Knowledge, Skills & Abilities

• Requires a detail-oriented individual with the ability to handle a high volume of multiple tasks and follow through to completion.
• Must be able to learn quickly and work independently to address a variety of complex issues.
• Must be flexible to adjust to the development and refinement of new processes and procedures.
• Knowledge of CPT and ICD-9 coding including coding from clinical documentation or auditing the coding of others.
• Extensive knowledge of Medicare regulations regarding teaching physicians, documentation guidelines, and other federal and state laws and regulations concerning clinical documentation, coding, and reimbursements.
• Knowledge of related clinical and business practices, policies, and procedures for billing and collections.
• Demonstrated communication, analytical and organizational skills are essential.
• Proficient in Microsoft Word applications including Excel and Word, Outlook or equivalent e-mail, and internet usage.
• Experience with IDX Billing and Accounts Receivable system, EPR, Meditech, Eclypsis, Epic, and other clinical information systems preferred.
• Must be self-motivated and comfortable working independently.

• Bachelor?s Degree in health care-related or business-related field.
• Four years of auditing/billing compliance.
• One professional coding certification (CCS-P, CPC, RHIA or RHIT) required by start date.
• Demonstrated training or teaching experience.
• Additional education may substitute for required experience and additional experience may substitute for required education, to the extent permitted by the JHU equivalency formula.

• Experience with Epic Billing and Accounts Receivable system, EPR, Meditech, Eclypsis, IDX and other clinical information systems.
• Seven years of experience.
• Additional coding certifications.

Classified Title: Sr. Billing Compliance Auditor 
Job Posting Title (Working Title): Sr. Compliance Auditor Trainer   
Role/Level/Range: ATP/04/PE  
Starting Salary Range: $73,300 - $128,300 Annually ($100,800 targeted; Commensurate with experience) 
Employee group: Full Time 
Schedule: M-F 8:30A-5PM 
Exempt Status: Exempt 
Location: Hybrid/Mount Washington Campus 
Department name: ???????Office of Compliance: Prof Fee Services  
Personnel area: School of Medicine 

About Johns Hopkins University

Johns Hopkins University remains committed to its founding principle, that education for all students should be grounded in exploration and discovery. Hopkins students are challenged not just to learn but also to advance learning itself. Critical thinking, problem solving, creativity, and entrepreneurship are all encouraged and nourished in this unique educational environment. After more than 130 years, Johns Hopkins remains a world leader in both teaching and research. Faculty members and their research colleagues at the university's Applied Physics Laboratory have each year since 1979 won Johns Hopkins more federal research and development funding than any other university. The university has nine academic divisions and campuses throughout the Baltimore-Washington area. The Krieger School of Arts and Sciences, the Whiting School of Engineering, the School of Education and the Carey Business School are based at the Homewood campus in northern Baltimore. The schools of Medicine, Public Health, and Nursing share a campus in east Baltimore with The Johns Hopkins Hospital. The Peabody Institute, a leading professional school of music, is located on Mount Vernon Place in downtown Bal...timore. The Paul H. Nitze School of Advanced International Studies is located in Washington's Dupont Circle area.

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