Compliance Specialist - Hybrid​/Remote

Job Summary

Provides compliance related coding reviews and auditing of faculty and physician documentation. The position will utilize coding knowledge to abstract, record and audit data from medical records. Provides support to areas related to documentation, regulatory education and auditing.

• Locates and compiles required medical documentation from a variety of different sources, ensuring completeness and accuracy in preparation for pre-audit meetings.
• Audits and reviews UBs and 1500s against provider and facility documentation to ensure compliance with University, state and federal guidelines.
• Reconciles clinic or provider visits and reports to the assigned Compliance Officer missing, incomplete or inconsistent documentation.
• Interacts with and provides auditing feedback to providers, hospital staff and clinic managers on billing related issues.
• Researches, maintains current knowledge, and interprets state and federal regulations regarding payments in health care to audit claims correctly.

Bachelor’s degree in Health Care Administration, Business Administration or a related field or equivalency (one year of education can be substituted for two years of related work experience); plus 2 years working experience with one of those years working in a compliance office. American Health Information Management ( AHIMA ) or American Academy of Professional Coders ( AAPC ) recognized certification such as:
Certified Professional Coder ( CPC ), Certified Professional Coder-Hospital ( CPC
-H) or a specific certification preferred by the Department.

Basic knowledge of clinical documentation requirements related to regulatory and reimbursement rules, the Medicare system and proficiency with computer software such as Microsoft Word and Excel; demonstrated human relations and effective communication skills also required.

Experience with University of Utah computer systems such as:
Power chart, Allegra, IDX , IDXRAD , Corporate Radar, Cognos, EPIC and ORMIS are highly preferred.

This position is not responsible for providing patient care.

Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.

Type:
Benefited Staff

The University is a participating employer with Utah Retirement Systems (“URS”). Eligible new hires with prior URS service, may elect to enroll in URS if they make the election before they become eligible for retirement (usually the first day of work). Contact Human Resources at  for information. Individuals who previously retired and are receiving monthly retirement benefits from URS are subject to URS’ post-retirement rules and restrictions.

Please contact Utah Retirement Systems at  or  or University Human Resource Management at  if you have questions regarding the post-retirement rules.

This position may require the successful completion of a criminal background check and/or drug screen.

The University of Utah values candidates who have experience working in settings with students and patients from all backgrounds and possess a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patients.

All qualified individuals are strongly encouraged to apply. Veterans’ preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities.

The University of Utah is an Affirmative Action/Equal Opportunity employer and does not discriminate based upon race, ethnicity, color, religion, national origin, age, disability, sex, sexual orientation, gender, gender identity, gender expression, pregnancy, pregnancy-related conditions, genetic information, or protected veteran’s status. The University does not discriminate on the basis of sex in the education program or activity that it operates, as required by Title IX and 34 CFR part 106.

The requirement not to discriminate in education programs or activities extends to admission and…