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Compliance Auditor
Universal Health Services

Location: King of Prussia, Pennsylvania
Work Setting: Hospital
Job Function:
Compliance
Job Type:
Full-Time

Introduction

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $11.4 billion in 2019. In 2020, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; ranked #281 on the Fortune 500; and in 2017, listed #275 in Forbes inaugural ranking of America’s Top 500 Public Companies. Headquartered in King of Prussia, PA, UHS has 90,000 employees and through its subsidiaries operates 26 acute care hospitals, 328 behavioral health facilities, 42 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 37 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.

Job Description

The UHS Corporate Business Office is hiring a Compliance Auditor to monitor and perform coding and charge audits to ensure compliance with governmental regulations and guidelines across the Acute Care system in additon to using key findings to develop and provide feedback, training, and education to all levels of personnel.

 

Key Responsibilities include:

 

  • Complete internal compliance coding and charging audits to compliment targeted reviews and results from various outside reviewers. Offers guidance for the ongoing coding and charge practice methodologies across the acute care hospitals, including inpatient and outpatient area focuses
  • Based on new requirements, audits findings, RACs, MACs, etc. prioritize and develop training/education protocols for UHS hospitals in ICD-9-CM, CPT-4, APC’s, Emergency Room Evaluation and Management, coding guidelines, modifier guidelines, and proper diagnosis and procedure code selection
  • Review and assess charge capture methodologies and the documentation of orders and clinical documentation to support charges. Review department charge sheets and charge entry modalities within ancillary systems. Identify areas of opportunity and monitor compliance with internal and regulatory standards related to charging, providing feedback and education to facility staff as needed
  • Investigate and resolve related issues in conjunction with the Charge Master Specialists including assessment of appropriate modifiers, accuracy of DRG assignment, completeness of coding, CCI and OCE edits, medical necessity, billing questions, denials, and charge reconciliation issues
  • Assist in preparation of policies related to compliance in coding and charging

Required Qualifications

Bachelor’s degree with 3 – 5 years’ experience in Acute hospital coding and charge practices.

  • RHIA or RHIT or Coding Certification (CCS) through AHIMA, CPC credentials a plus
  • Proficient in current Coding and Charging Practices, including UHDDS, AHIMA, CMS and other governmental regulations and guidelines
  • Proficient in chart review, coding methodologies with the ability to understand hospital claims, chargemaster, and regulatory and payer communications and payment methodologies
  • Knowledge and experience using EMRs, medical necessity software, charge master systems and Microsoft Office
  • Travel up to 25%

Compensation/Benefits

This opportunity provides a rewarding career, challenging and rewarding work environment as well as growth and development opportunities within UHS and its subsidiaries, including competitive compensation, excellent Medical, Dental, Vision and Prescription Drug Plan, and 401k with company match.

Apply Online: https://jobs.uhsinc.com/corporate/jobs/68507?lang=en-us

Posted: January 25, 2021 at 3:36 PM
Post ID: 57759

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