*Billing Compliance Manager - Tulsa

Job Description

Responsible for the development, implementation, and oversight of daily operations of healthcare billing compliance activities.

Organizes and directs internal and external compliance with Federal and State statutory and regulatory requirements and organizational policies with regard to compliance documentation and billing of medical services.

Provides education and training to faculty and staff on various compliance issues. Develops or assists in development of policies and procedures to meet regulatory standards in addition to organizational objectives.

Promotes a culture of the highest standard of ethics and integrity.

Duties :

• Evaluates the implementation of new or changed regulatory requirements and identifies potential impacts.
• Advises operational units as required.
• Organizes and directs internal and external compliance with Federal, State, and local regulations with regard to compliance documentation and coding of medical services.
• Develops and directs focused reviews of potential areas of risks and vulnerability.
• Presents findings to management and faculty to promote awareness of regulatory standards.
• Recommends to the Compliance Director potential strategy and activities to ensure billing compliance
• Provides guidance and assistance to faculty and departmental staff in operational statutory and regulatory requirements.
• Develops and executes claims data mining queries, data retrieval, analysis and management of validation reviews, and resulting educational activities to further ensure compliance.
• Makes recommendations for remediation.
• Recommends and develops changes to improve program effectiveness.
• Functions as an internal consultant on special projects or initiatives as assigned.
• Assists or develops policies and procedures to meet regulatory standards in addition to organizational objectives.
• May assist legal counsel with compliance requests from internal and external regulatory bodies.
• Performs research via electronic and other media to ensure documentation is current and relevant.
• Advises departments and faculty of new or changing regulatory issues relating to their specialties.
• Presents in-house seminars on topics of documentation procedures and teaching regulations.
• Partners with internal customers to develop and deliver communications and educational activities designed to promote an understanding of compliance issues, laws and regulations, as well as the consequences of non-compliance.
• Effectively responds to alleged compliance violations, to include but not limited to documentation and recommendations for corrective action.
• Seeks educational opportunities to stay abreast of annual coding updates.
• Performs other duties as needed to successfully fulfill the function of the position.

Job Requirements

Required Education : Bachelor's degree in Healthcare or related field, AND :

36 months experience in regulatory or health care coding.

Equivalency / Substitution : Experience or a combination of education & related experience can be considered in lieu of degree.

A one-to-one ratio is used to determine the number of years of experience required in place of a degree.

Skills :

• Knowledge of health care administration, Federal, State, and local regulatory / compliance policies and procedures
• Knowledge of governmental regulations and reimbursement requirements
• Knowledge of human resource management practices including supervision and staff development
• Knowledge of medical terminology and documentation
• Knowledge of internal and external regulatory compliance guidelines, e.g., HIPAA
• Knowledge of human resource management practices including supervision and staff development
• Working knowledge of CPT and ICD-9 coding
• Ability to exercise initiative, judgement, problem solving, and decision making
• Ability to develop and maintain effective relationships with physicians, staff, regulators, and administration
• Ability to analyze and interpret data.
• Ability to research and prepare reports
• Ability to communicate clearly
• Demonstrate self-motivation, initiative, and practical learning skills
• Ability to complete multiple tasks in a timely and accurate manner

Advertised Physical Requirements :

• Physical : Must be able to work in sitting position. Ability to engage in repetitive motion.
• Environmental : Standard Office Work Environment.

Why You Belong at the University of Oklahoma : The University of Oklahoma fosters an inclusive culture of respect and civility, belonging, and access, which are essential to our collective pursuit of excellence and our determination to change lives.

The unique talents, perspectives, and experiences of our community enrich the learning, and working environment at OU, inspiring us to harness our innovation, creativity, and collaboration for the advancement of people everywhere.

Equal Employment Opportunity Statement : The University of Oklahoma, in compliance with all applicable federal and state laws and regulations, does not discriminate based on race, color, national origin, sex, sexual orientation, genetic information, gender identity, gender expression, age, religion, disability, political beliefs, or status as a veteran in any of its policies, practices, or procedures.

This includes, but is not limited to, admissions, employment, financial aid, housing, services in educational programs or activities, and health care services that the University operates or provides.

Hiring contingent upon a Background Check? : YesSpecial Indications : None

Job Posting

Jun 17, 2024