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Compliance Audit Specialist II - Office of Physician Billing Compliance

University of Florida

Classification Title:

Compliance Audit Specialist II

Job Description:

The Compliance Audit Specialist II in the Office of Physician Billing Compliance conducts regulatory compliance audits of the University of Florida, College of Medicine departments, institutes, and centers to ensure data integrity and compliance with federal and state regulations, reviewing medical and billing records to determine if service and documentation requirements are met. Works in collaboration with the Compliance Audit Specialist manager and Director of Physician Billing Compliance to provide input and assist in the development of any applicable training and education content. 

More About This Role

Conduct compliance audits of the University of Florida College of Medicine departments, institutes, and centers to ensure data integrity, compliance with federal and state regulations pertaining to, but not limited to provider billing services. Review medical and billing records to determine if service and documentation requirements are met. Clearly document findings related to work performed. Communicate any identified patterns of error that may create institutional risk. 

Contribute to audit findings report and assist in the organization of documentation to support and communicate audit findings. May oversee clerical search of paper or electronic health records. These findings may lead to substantive refunds to the College of Medicine, and/or disciplinary action for faculty, residents, non-physician providers and operational staff.

Draft summary reports, communications with physicians, compilation of findings, discussion of findings. Familiarize with the structure of our clinical practice and participates in recommendations on educational and internal control policies to improve compliance plan effectiveness and operational outcomes. 

Assist with the development of training sessions for providers, professional fee billing staff and others on a regularly scheduled or ad hoc basis

Stay current on coding changes and seek institutional interpretations based on changes. Research current federal, state and payer documentation, billing and coding rules and regulations. 

Remote Work Opportunity

The University of Florida recognizes the value of telecommuting in fostering a flexible work environment. Therefore, consideration may be given to remote within the Gainesville area after 6 months of successful performance.

We Offer Exceptional Benefits

  • Medical, Dental, and Vision Insurance
  • Life and Disability Insurance
  • Florida Retirement System Retirement Plans (Investment or Pension)
  • Paid Time Off (11 paid holidays, paid family leave, sick and vacation)
  • Personal and Professional Development Opportunities (UF Training & Organization Development, LinkedIn Learning)
  • Tuition Assistance (UF Employee Education Program)
  • Public Service Loan Forgiveness (PSLF) Eligible Employer 

Expected Salary:

$21.00 - $22.25 per hour

Minimum Requirements:

  • High school diploma, or equivalent, and two (2) years of relevant experience. Appropriate college course work may substitute at an equivalent rate for the required experience.
  • Current certification in one of the following:
  • Certified Professional Coder (CPC) (American Academy of Professional Coders)
  • Certified Coding Specialist (CCS-P) (American Health Information Management Association)
  • Certified Coding Associate (CCA) (American Health Information Management Association)
  • Certified in Healthcare Compliance (CHC) or Certified in Healthcare Research Compliance (CHRC)
  • Certified in Healthcare Privacy Compliance (CHPC)
  • Certified Compliance & Ethics Professional (CCEP)
  • Certified Compliance & Ethics Professional-International (CCEP-I)

Preferred Qualifications:

  • Extensive coding experience in an academic setting.
  • High school diploma and three (3) years of appropriate experience. Appropriate college course work or vocational /technical training may substitute at an equivalent rate for experience. 
  • Knowledge and experience with electronic health records and databases, and Microsoft Word.
  • Excellent proofreading abilities and attention to detail. 
  • Demonstrated ability to handle telephone communication in appropriate manner.
  • Flexible and willing to assume new tasks
  • Act in a professional manner when dealing with staff and general public.
  • Knowledge of related clinical and business practices, policies, and procedures for billing and collection of professional fee services, and audit processes.
  • Experience in review of medical record documentation in an electronic health record.

Special Instructions to Applicants:

To apply, please upload your current resume, a letter of interest, and three professional references with your application.

This position is eligible for veteran’s preference. If you are claiming veteran’s preference, please upload a copy of your DD 214 Member Copy 4 with your application for consideration. See our Veteran's Preference Page for more specific information.

If an accommodation due to a disability is needed to apply for this position, please call 352-392-2477 or the Florida Relay System at 800-955-8771 (TDD). Hiring is contingent upon eligibility to work in the US. Searches are conducted in accordance with Florida's Sunshine Law.

Application must be submitted by 11:55 p.m. (ET) of the posting end date.

Health Assessment Required: No

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Confirmed 21 hours ago. Posted 30+ days ago.

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