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Emory Healthcare/Emory University Billing Compliance Analyst in Atlanta, Georgia

Overview

All candidates must have auditing experience and be a certified coder.

At Emory Healthcare, we integrate science and caring to change the face of health care. Our team members are courageous individuals who are willing to challenge the status quo and help find solutions to complex problems. We’re empowered to influence change for, and with, our patients, their families, the community and each other.

As one of the leading academic medical systems, we’re eager to share what we learn with hospitals around the country, and the world. We’ve got the backing, knowledge, experience and permission to lead the way in developing new and better approaches to preventing and treating disease, and our patients get treatments years before anyone else.

We’re defining a new standard of care for humankind. Are YOU ready to join us?

Description

JOB DESCRIPTION:

  • The Billing Compliance Analyst will work directly with the Emory Hospitals Revenue Cycle team and provide assistance with coordinating the billing compliance activities.

  • Assist with reviewing and analyzing hospital claims to ensure compliance with applicable regulations and guidelines.

  • Conducts monthly review (Billing QA) for hospital claims.

  • Formulates recommendations based upon the findings and communicating them to the appropriate personnel.

  • Assists with reviewing and analyzing claims data for potential compliance concerns.

  • Organizes with applicable parties to complete action items identified from various reviews.

  • Assists with coordinating and tracking of revenue cycle/government audits including CERT, MSP audits, Medicaid Credit Balances and Kepro 2 Midnight review, etc.

  • Performs other duties or special projects to support the hospital revenue cycle team.

MINIMUM QUALIFICATIONS:

  • Bachelor's Degree in related field is preferred.

  • Relevant combination of education and experience may be considered in lieu of a degree.

  • Five years of experience in coding and/or auditing.

  • Familiarity with hospital operations.

  • Recent experience with regulatory research and an understanding of the regulatory environment particularly related to healthcare revenue cycle.

  • Knowledge of hospital billing and reimbursement of government payers.

  • Excellent communication, organizational, project management and computer skills required.

  • Certified as a coding specialist (CCS), coding specialist physician (CCSP), procedural coder - hospital (CPC-H), OR Certified professional coder (CPC).

PHYSICAL REQUIREMENTS: 1-10 lbs 0-33% of the work day (occasionally), negligible 34-66% of the workday (frequently), negligible 67-100% of the workday (constantly). Lifting 10 lbs max, carrying of small articles such as dockets, ledgers, files, small tools, occasional standing & walking, frequent sitting, close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure, Bio-hazardous waste. chemicals/gases/fumes/vapors, communicable diseases, electrical shock, floor surfaces, hot/cold temperatures, indoor/outdoor conditions, latex, lighting patient care/handling injuries, radiation, shift work, travel may be required, use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

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Division Emory Healthcare Inc.

Campus Location Atlanta, GA, 30308

Campus Location US-GA-Atlanta

Department EHI Patient Financial Services

Job Type Regular Full-Time

Job Number 60817

Job Category Revenue Cycle & Managed Care

Schedule 8a-4:30p

Standard Hours 40 Hours

Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.

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