Compliance Audit Specialist II - Physician Billing Compliance

Compliance Audit Specialist II

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.

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

The Compliance Audit Specialist Conducts regulatory compliance audits of the University of Florida, College of Medicine departments, institutes and centers to ensure data integrity and compliance with federal and state regulations, reviewing medical and billing records to determine if service and documentation requirements are met. Works in collaboration with the Compliance Audit Specialist manager and Director of Physician Billing Compliance to provide input and assist in the development of any applicable training and education content.

About this Role

• Conduct 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. Reviews medical and billing records to determine if service and documentation requirements are met. Clearly documents findings related to work performed. Communicate any identified patterns of error that may create institutional risk.

• Contributes to audit findings report and assist in the organization of documentation to support and communicate audit findings. May direct/supervise clerical search of paper or electronic health records. These findings may lead to substantive refunds to the College of Medicine, and/or disciplinary action for faculty, residents, non-physician providers and operational staff.

• Drafts summary reports, communications with physicians, compilation of findings, discussion of findings. Familiarizes with the structure of our clinical practice and participates in recommendations on educational and internal control policies to improve compliance plan effectiveness and operational outcomes.

• Assist with the development of training sessions for providers, professional fee billing staff and others on a regularly scheduled or ad hoc basis

• Responsible for current reading to remain appraised of coding changes, and seek institutional interpretations.

• Researches current federal, state and payer documentation, billing and coding rules and regulations.

About the College of Medicine

The University of Florida's College of Medicine is committed to advancing health through education, research, and patient care. With a focus on innovation and excellence, the college prepares future healthcare leaders through a rigorous curriculum that combines basic sciences with hands-on clinical experience. The College of Medicine emphasizes interdisciplinary collaboration and community engagement, fostering and environment where students, faculty, and staff work together to improve healthcare outcomes. The College is home to cutting-edge research initiatives and state-of-the-art facilities, providing an exceptional training ground for aspiring medical professionals. Dedicated to enhancing health care, the College of Medicine plays an impactful role in shaping the future of medicine. 

For more information about the College of Medicine and its programs, visit College of Medicine.