Compliance Audit Specialist II

Summary

Conducts testing and monitoring activities for the University clinical practice related to compliance with federal and state regulatory requirements for physician/provider documentation and billing. May conduct and/or supervise responses to requests for documentation from external integrity entities and other regulatory bodies.

Examples of Work

Job functions are specific duties that would be included in the essential functions of the job description. These functions are not all-inclusive nor do they cover the full extent of the duties performed.

• Conducts specialty specific or multi-specialty compliance audits of the University of Florida College of Medicine departments, institutes, and centers to ensure data integrity, compliance with federal and state regulations pertaining to, but not limited to provider billing services.
• Keeps appraised of coding changes, and seeks institutional interpretations.
• Makes recommendations on educational/internal control policies to improve compliance plan effectiveness and operational outcomes.
• Conducts research on regulatory history and current status of regulatory requirements.
• Reviews work papers and findings of Compliance Audit Specialist I.
• Conduct audits and clearly documents findings related to work performed.
• Assist in planning process, participate in information gathering, meetings, compilation of work papers, monitoring provider billing services, compilation of findings.
• Contribute to the assessment of risks and compilation of audit narrative describing systems and internal controls. Maintains an understanding of the operation, system processes and procedures used in the areas being audited.
• Participates in exit conferences, providing clarification and supporting information as necessary.

Education and Experience

High School Diploma or equivalent and two years of appropriate experience. Appropriate college course work may substitute at an equivalent rate for the required experience.

Licensure and Certification

Certified Professional Coder (CPC)/ American Academy of Professional Coders or Certified Coding Specialist (CCS-P) (American Health Information Management Association) or Certified Coding Associate (CCA) (American Health Information Management Association) or Certified in Healthcare Compliance (CHC) or Certified in Healthcare Research Compliance (CHRC) or Certified in Healthcare Privacy Compliance (CHPC) or Certified Compliance & Ethics Professional (CCEP) or Certified Compliance & Ethics Professional-International (CCEP-I) is required

Supervision

None

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