HSC RAC Administration Manager - Physician Bill Compliance

HSC RAC Administration Manager - Physician Bill Compliance

Apply now Job no: 539103
Work type: Staff Full-Time
Location: Main Campus (Gainesville, FL)
Categories: Health Care Administration/Support, Legal/Audit Services/Compliance
Department:  - MD-PHYSICIAN BILL COMPLIANCE

Classification

Title:

HSC RAC Administration Manager

Job Description:

The HSC RAC Administration Manager reports directly to the Physician Billing Compliance Director. The HSC RAC Administration Manager is responsible for managing the Physician Billing Compliance Department’s auditing staff and planning the Departmental auditing activities related to physician billing and coding, to ensure smooth operation and timely completion. This position is also responsible for completion and documentation of federally required educational effort for the College of Medicine as a whole.

The Manager will be heavily involved in the supervision and implementation of new audit tools and processes, and the modification of existing audit tools and processes for improvement. Provide daily management of staff and coordinates compliance activities to achieve work plan and departmental goals. The Manager works closely with the Director of Physician Billing Compliance to help promote and administer above mentioned Compliance missions for UFCOM.

• Study compliance periodicals, list-serves, and governmental communications, and consult with the Director and COM General Counsel to ensure that instruction and guidance are accurately interpreted.
• Draft, coordinate on-line implementation, and monitor completion of on-line annual compliance update training modules for targeted audiences.
• Work to ensure all elements of an effective program are met through auditing and monitoring, training and education, policy development, maintaining open lines of communication, follow investigation protocols and respond to reported, suspected or confirmed non-compliant issues.
• Work to ensure federally required searches for ineligible/sanctioned persons, as well downstream audits.
• Work with Chairs, physicians and non-physician providers (APPs) to identify and correct issues associated with non-compliant billing.
• Provide one-on-one training for providers (physicians and non-physician providers) when the results of regular/follow-up/otherwise warranted indicate additional training in federal and state documentation requirements
• The aforementioned items one and two require specialty specific knowledge at a tertiary care center level: such training must be provided in a diplomatic and clear manner, and preparation of specialty specific guidance, templates, specific examples of from patient records essential.
• Work to ensure risk reduction and compliance with federal and state rules and regulations and organizational policies by providing compliance guidance to staff and leadership.
• Make regular compliance presentations to the COM onboarding orientations for Faculty, Regional Provider Network, and Staff.
• Conduct searches for sanctioned persons in federal databases in accordance with federal requirements, and maintains databases to demonstrate University efforts. Perform downstream audits to demonstrate the controls are in place and to ensure accuracy of the mentoring process.
• Responsible for the compliance website to update the regulatory as well the educational related materials.
• Assist college administrators to resolve specific educational or training problems and disseminate information in regard to federal and state regulations and College policy.
• Assist in review of Encounter forms, templates and coordinate the Compliance Awareness Month with Shands Compliance Team.
• Assist in planning process, information gathering, organizing meetings, monitoring provider billing services, and compilation of audit findings. Contribute to the assessment of risks and compilation of audit narratives describing systems and internal controls. Develop an understanding of the operations, system processes and procedures used in the areas being audited.

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