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Manager Billing Compliance - Faculty Practice Plan (Hybrid)

companyWashington University In St. Louis School of Arts&Sciences
location1 Barnes Jewish Hospital Plaza, St. Louis, MO 63110, USA
PublishedPublished: 5/7/2024
Faculty
Full Time

Scheduled Hours

40

Position Summary

Manages the billing audit function for Washington University Clinical Associates (WUCA), ensuring that audit services are conducted in accordance with WUSM policy. Acts as a resource for compliance and coding education; supervises educator and/or analyst staff to meet objectives.

Job Description

Primary Duties & Responsibilities

  • Formulates an annual plan for required audits for all WUCA practices and ensures completion of audit activity in order to maintain required audit schedule: responsible for ensuring that all WUCA providers are audited, at a minimum once a year, with new providers audited within three months of hire. Maintains documentation of audit schedule and prepares reports for senior leadership as needed. Prepares quarterly reports on audit findings, high risk trends and implementation of corrective actions.
  • Acts as a resource to WUCA practices and physicians for education of new regulations, specialty specific coding/billing compliance inquiries, coding trends, documentation for midlevel providers etc. 
  • Follows up on Office of Billing Compliance (OPBC) audits within required timeframe: meets with physicians and practice staff, addresses questions, researches findings and prepares required follow-up reports in collaboration with physicians and WUCA management. Works with practices to implement specific audit recommendations as needed. 
  • Processes audit appeals received from WUCA practices.
  • Ensures all hard copy and electronic audits and reports are maintained in accordance with compliance office record retention policy.
  • Provides superior customer service and acts as overall resource for coding and documentation questions. 
  • Reports issues of noncompliance identified though the audit process as required.
  • Develops, maintains, and modifies all audit tools and aids to ensure compliance, including modifications necessary to reflect changes in regulation and policy as they occur. 
  • Supervises compliance staff that conduct education, audits and analyses on behalf of WUCA.
  • Participates as member of WUCA support team in onboarding of new WUCA practices as needed. 
  • Special audit and compliance related projects as assigned.

Working Conditions

  • Office environment.  
  • Position requires occasional local travel to practice locations.

Preferred Qualifications

  • Knowledge of Center for Medicare and Medicaid Services documentation and billing regulations.
  • Experience in medical record review for documentation and/or utilization review or continuous quality improvement.
  • Diverse clinical background, good communication skills and ability to work independently, knowledge of ICD-10 and CPT coding.
  • Working knowledge using a personal computer and applications; specifically, word processing and spreadsheets.
  • Experience with EPIC billing system. 

Required Qualifications

  • Bachelor’s degree and three years related experience or equivalent combination of education and experience.
  • Experience in health care related field required.
  • Registered Nurse (RN), Registered Health Information Administrator (RHIA) and/or Registered Health Information Technician (RHIT).

Grade

G13

Salary Range

$64,700.00 - $110,500.00 / AnnuallyThe salary range reflects base salaries paid for positions in a given job grade across the University. Individual rates within the range will be determined by factors including one's qualifications and performance, equity with others in the department, market rates for positions within the same grade and department budget.

Questions

For frequently asked questions about the application process, please refer to our External Applicant FAQ.

Accommodation

If you are unable to use our online application system and would like an accommodation, please emailCandidateQuestions@wustl.eduor call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request.

Pre-Employment Screening

All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. The screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an 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.

Benefits Statement

Personal

  • Up to 22 days of vacation, 10 recognized holidays, and sick time.
  • Competitive health insurance packages with priority appointments and lower copays/coinsurance.
  • Want to Live Near Your Work and/or improve your commute? Take advantage of our free Metro transit U-Pass for eligible employees. We also offer a forgivable home loan of up to $12,500 for closing costs and a down payment for homes in eligible neighborhoods.
  • WashU provides eligible employees with a defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions and university contributions starting at 7%.

Wellness

  • Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more!

Family

  • We offer 4 weeks of caregiver leave to bond with your new child. Family care resources are also available for your continued childcare needs. Need adult care? We’ve got you covered.
  • WashU covers the cost of tuition for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us.

For policies, detailed benefits, and eligibility, please visit: https://hr.wustl.edu/benefits/

EEO/AA Statement

Washington University in St. Louis is committed to the principles and practices of equal employment opportunity and especially encourages applications by those from underrepresented groups. It is the University’s policy to provide equal opportunity and access to persons in all job titles without regard to race, ethnicity, color, national origin, age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information.

Diversity Statement

Washington University is dedicated to building a diverse community of individuals who are committed to contributing to an inclusive environment – fostering respect for all and welcoming individuals from diverse backgrounds, experiences and perspectives. Individuals with a commitment to these values are encouraged to apply.