DCG Billing Compliance Analyst

Overview

Job Title: DCG Billing Compliance Analyst

Location: Augusta University

Regular/Temporary: Regular

Full/Part Time: Full-Time

Job : 289466

Augusta University is Georgia's innovation center for education and health care, training the next generation of innovators, leaders, and healthcare providers in classrooms and clinics on four campuses in Augusta and locations across the state. Augusta University has a mission and values that underpin how we operate. Our USG values include Integrity, Excellence, Accountability, and Respect.

Location details:
Augusta University – Health Sciences Campus (1120 15th Street, Augusta, GA 30912) and Summerville Campus (2500 Walton Way, Augusta, GA 30904).

The Dental College of Georgia at Augusta University provides dental education through hands-on learning, research, patient care, and service. Treatments may be delivered in student clinics, resident care, or faculty practice across multiple clinics in Georgia.

The DCG Billing Compliance Analyst will conduct internal billing and documentation audits and compliance investigations; produce audit reports and findings with viable recommendations; monitor internal compliance reports.

• 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 and analyze corrective action plans to ensure DCG billing operations align with DCG and Augusta University policies and vendor contracts, and adhere to regulatory requirements.
• Education & Training: Provide periodic training to providers and employees on DCG and Augusta University compliance policies, including regulatory requirements (e.g., False Claims Act, Stark Laws, Anti-Kickback Statutes) for billing, coding, and documentation.
• Reporting: Prepare and submit annual and interim audit reports; maintain detailed records of audit and monitoring activities; 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, and coding guidance (CDT, CPT, ICD-10-CM, HCPCS) through conferences and webinars.
• Other Duties: Perform other job-related duties as assigned.

• Required: Bachelor’s degree in healthcare or business-related field with two years of clinical or administrative experience in dental or medical healthcare; certified coder with certification from AAPC (CPC, CPMA), DANB, or AHIMA; or equivalent (third-party and federal payor insurance background with knowledge of coding, billing, documentation, and reimbursement).
• Or: Associate’s degree with four years of clinical or administrative experience and relevant certification as above.

• Master’s degree in healthcare or business-related field.
• Advanced knowledge of CMS and other third-party payor coding, billing, and documentation criteria.
• Four or more years of auditing/billing experience across multiple specialties; five+ years in compliance auditing and monitoring; CHC certification is a plus.

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

Certified coder with certification from AAPC (CPC, CPMA), DANB, or AHIMA.

Shift: Days/Mon-Fri

Pay Band: B9

Salary:
Minimum $48,800 annual; compensation commensurate with qualifications within the established range.

Recruitment Period:
Until Filled. Augusta University offers a variety of benefits to full-time employees,…