DCG Billing Compliance Analyst

Overview

Join to apply for the DCG Billing Compliance Analyst role at Augusta University

Location:

Augusta, GA

• Auditing & Monitoring:
  Perform interim and annual billing and documentation audits across multiple dental and medical specialties and programs for faculty, resident, and student providers to identify potential compliance risks and assist with corrective action plans.
• Monitor and analyze missing charge and procedure reports; communicate with Program Directors on chart deficiencies; verify chart updates; monitor corrective action plans to ensure billing operations align with policies and regulations.
• Education & Training:
  Provide periodic training to providers and employees on DCG and Augusta University compliance policies, including regulatory requirements for billing, coding, and documentation referrals and contracts.
• Reporting:
  Prepare and submit annual and interim audit reports; maintain detailed records of audit and monitoring activities for reporting to the Director of Regulatory Compliance; analyze data to identify trends and inform training or corrective actions.
• Investigations:
  Conduct investigations of potential compliance violations using USG guidance; perform root cause analyses; prepare reports per USG and AU protocols.
• Professional Development:
  Maintain current knowledge of payor billing rules, coding, documentation, and reimbursement criteria; pursue ongoing professional development.
• Other duties as assigned.

• Required Qualifications
• Bachelor's degree in healthcare or business-related field with two years of clinical or administrative experience in dental or medical healthcare; certification as CPC, CPMA, DANB, AHIMA, or equivalent; knowledge of third-party and federal payor insurance, coding, billing, documentation, and reimbursement.
• OR
• Associate's degree in healthcare or business-related field with four years of clinical or administrative experience in dental or medical healthcare; same certifications and knowledge as above.

• Master's degree in healthcare or business-related field (preferred).
• Advanced knowledge of CMS and other third-party payor coding, billing, and documentation criteria.
• Four or more years of clinical or administrative experience in auditing, billing, coding, and documentation across multiple specialties; five or more years in compliance auditing and monitoring; CHC certification.
• Knowledge of audit sampling methodologies.

• Knowledge:
  Healthcare compliance concepts and CMS reimbursement principles.
• Skills:
  Strong project management, initiative, and ability to work independently.
• Abilities:
  Maintain confidentiality; define problems; collect data; present information; apply systematic problem-solving.

• Certified coder with CPC/CPMA/DANB/AHIMA or similar from AAPC or AHIMA.

• Shift: Days, M-F
• Pay Band: B9
• Salary:
  Minimum $48,800 per year, commensurate with qualifications
• Benefits:
  Health and dental insurance, retirement plan, vacation, sick leave, holidays; tuition assistance for long-tenured full-time employees; other benefits as eligible.

• Background check required prior to starting; credit check for positions of trust or departmental card use where applicable; motor vehicle records if driving university vehicles; verification of degree transcripts for faculty hires.

Augusta University is an equal opportunity employer welcoming applicants from underrepresented groups, including individuals with disabilities and veterans.

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Note:

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