Billing Compliance Manager | Phys Billing Complance D/F | Day - UF Health

Job Duties

The Billing Compliance Manager reports directly to the Director of Compliance and is responsible for maintaining the day-to-day operations of the Office of Physician Billing Compliance. The Manager will oversee the department staff and ensure compliance with all regulations and guidelines governing billing for professional services.

Essential Functions

• Oversees accurate auditing of chart documentation for compliance with Evaluation and Management, procedural, diagnosis, Teaching Physician guidelines, and payor guidelines for Federal and State healthcare programs including Medicare, Florida Medicaid, Georgia Medicaid, and Tricare.

• Ensures adequate records are maintained to document compliance efforts and corrective actions.

• Presents audit results to appropriate faculty and billing personnel by participating in audit conferences.

• Identifies remedial training needs of providers or billing staff through audit process and coordinates training with the faculty practice plan education department.

• Monitors and manages salaries of direct reports and operating expenses as specified in departmental budget.

• Tracks performance and provides performance evaluations on direct reports.

• All other duties as assigned.

Temperament

Adhere to company policies and procedures, demonstrate the core values and Hospitality behaviors, resolve conflict through open, honest, professional communication, demonstrate positive and enthusiastic attitude, keep supervisor and leadership apprised of issues, and seek opportunities to recognize others.

Skills, Knowledge, Abilities

• Ability to gather data, compile information, and prepare reports.

• Ability to maintain confidential and sensitive information.

• Proficiency with procedural coding (including Level II HCPCs) and diagnosis coding.

• Proficiency with Evaluation and Management coding as well as federal and state regulatory guidance relevant to professional billing.

• Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.

• Ability to manage multiple priorities and meet deadlines.

• Ability to organize and prioritize assignments to work independently as well as a collaborative team member.

• Proficiency with medical terminology.

• Ability to effectively deliver presentations to small and large groups.

• Proficient in use of a Windows OS computer and MS office suite.

• Ability to supervise and train staff by organizing, prioritizing, and scheduling work assignments.

• Proficient in use of a Windows OS computer and office suite including word processing and spreadsheets.

Experience Requirements

2 years     Compliance auditing experience                                                        required

5 years     Physician billing, billing compliance, or related healthcare area   required

3 years     Supervisory experience                                                                         required

2 years     Medicare, Medicaid, and Tricare/Champus regulations

                  pertaining to billing and reimbursement                                           required

5 years     Comprehensive experience with physician coding, billing,

                  reimbursement and compliance maybe substituted for

                  health care degree                                                                               preferred

Education Requirements

High School Diploma or GED                                                                       required

Associates                                                                                                       required

Bachelors - Nursing, Health Care, or related field                                  preferred

5 years of relevant work experience required

Certified Professional Coder (CPC)                                            required at time of hire OR

Certified Coding Specialist-Physician Based (CCS-P)              required at time of hire

CPMA Credential                                                                          required within 6 months

UFJPI is an Equal Opportunity Employer and Drug Free Workplace