Compliance Review/Claims Analyst - Medicine - Business Office
Washington University in St. Louis
Location: St. Louis, Missouri
Internal Number: JR72292
This position requires frequent short distance travel to physiciansâ™ offices/affiliated institutions, otherwise normal office environment with variable pressures and time constraints.
Primary Duties & Responsibility
Ensures the coding protocols adheres to standards consistent with official CPT procedural and ICD-10-CM diagnosis coding standards, University policy and government & third party regulations. Keeps abreast of changes to CPT and ICD-10-CM. Organizes, interprets, condenses and disseminates changes and procedures to the appropriate supervisors, staff, physicians and physician staff in a timely manner.
Schedules & performs medical chart audits for correct coding and compliance with governmental and third party regulations. Provides feedback to practitioners regarding audit results and education on proper coding techniques and/or compliance regulations. Provides education to new providers and residents on proper documentation & billing compliance.
Monitors physician note completion and provide reports to providers on regular basis.
Ensures all eligible employees in the department complete their annual billing compliance training. Liaison with School of Medicineâ™s Office of Physician Billing & Compliance. Assists with development of ICD-10 and serves as university contact for ICD-10 sub-committee. Maintains up-to date coding and compliance files on each practitioner including departmental signature log.
Assists clinical services staff with policy interpretation, coding questions, and appeal letters as needed.
Assists with investigating & pursuing new billing opportunities specific to the department.
Miscellaneous duties as assigned.
Frequent short distance travel to physiciansâ™ offices/affiliated institutions, otherwise normal office environment with variable pressures and time constraints.
Current RHIT/RHIA certification or CPC/CCS-P certification.
Minimum of three years of experience in physician coding and compliance.
Expertise in CPT-4, HCPCS and ICD-10 Coding & compliance regulations.
Knowledge of compliance and third party regulations.
Ability to communicate effectively with healthcare practitioners and co-workers.
Working knowledge of computers, medical terminology and medical claims review.
Ability to work with a high degree of independence.
Associateâ™s degree with three years of experience in health-related field or combined education and experience in a health-related field of five years.
$59,300.00 - $92,000.00 / 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.
If you are unable to use our online application system and would like an accommodation, please emailÂ CandidateQuestions@wustl.eduÂ or call the dedicated accommodation inquiry number at 314-935-1149 and leave a voicemail with the nature of your request.
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.
Washington University in St. Louis is committed to providing a comprehensive and competitive benefits package to our employees. Benefits eligibility is subject to employment status, full-time equivalent (FTE) workload, and weekly standard hours. Please visit our website at https://hr.wustl.edu/benefits/ to view a summary of benefits.
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 Universityâ™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.
Washington University is dedicated to building a diverse community of individuals who are committed to contributing to an inclusive environment â“ fostering respect for all and welcoming individuals from diverse backgrounds, experiences and perspectives. Individuals with a commitment to these values are encouraged to apply.
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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.
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