Home Health Focus AI · 4 hours ago
Physician Billing Compliance Analyst | Physician Billing Compliance | Day - Remote
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Responsibilities
Within designated timeframes and by utilizing medical management systems, audit chart documentation and professional billing for compliance with E&M, CPT procedure coding, ICD-10-CM diagnosis coding, teaching physician guidelines, payer specific polices and regulatory requirements.
Perform analysis of audit findings and summarize for placement in the Physician Billing Compliance Services (“PBC”) central database.
Participate in opening and closing audit conferences with representatives of the COM-Jax and UFJPI.
Identify remedial training needs through audit process and if necessary, conduct remedial training with providers and/or UFJPI billing staff.
Assist in the development of policies and procedures to complete work in accordance with the COM – Jax Billing Compliance Plan.
Problem solve issues identified during the audit process.
Assist with creation and performance of audits through the utilization of various auditing software programs.
Assist Manager and Director of PBC with research and analysis for special projects and other duties as assigned.
All other duties as assigned.
Qualification
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Required
2 years Medical billing required
4 years Medical coding (procedural and diagnosis) for multi-specialty providers required
3 years Medicare, Medicaid, and Tricare payment and reimbursement rules required
3 years Medical record chart auditing for professional billing required
1 Year Medical Management Information Systems (EPIC Preferred) Required
High School Diploma or GED required
Certified Coding Specialist required or at time of hire
Certified Coding Specialist - Physician Based(CCS-P) - AHIMA required or at time of hire
Certified Professional Coder (CPC) required or at time of hire
Certified Professional Medical Auditor (CPMA) required within 6 months
Preferred
1 year Auditing software applications (e.g. MDaudit, Compliance Risk Analyzer) preferred
Associates Business or health care industry related field preferred
Company
Home Health Focus AI
HomeHealthFocus.ai is an innovative data platform that tracks and analyzes critical information from home care, hospice, and senior living companies across the United States.
Funding
Current Stage
Early StageCompany data provided by crunchbase