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Augusta University

DCG Billing Compliance Analyst

Augusta University, Augusta, Georgia, United States, 30910

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DCG Billing Compliance Analyst

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Augusta University Location: Augusta, GA Responsibilities

Auditing & Monitoring: Perform interim and annual billing and documentation audits across multiple dental and medical specialties and programs for faculty, resident, and student providers to identify potential compliance risks and assist with corrective action plans. Monitor and analyze missing charge and procedure reports; communicate with Program Directors on chart deficiencies; verify chart updates; monitor corrective action plans to ensure billing operations align with policies and regulations. Education & Training: Provide periodic training to providers and employees on DCG and Augusta University compliance policies, including regulatory requirements for billing, coding, and documentation referrals and contracts. Reporting: Prepare and submit annual and interim audit reports; maintain detailed records of audit and monitoring activities for reporting to the Director of Regulatory Compliance; analyze data to identify trends and inform training or corrective actions. Investigations: Conduct investigations of potential compliance violations using USG guidance; perform root cause analyses; prepare reports per USG and AU protocols. Professional Development: Maintain current knowledge of payor billing rules, coding, documentation, and reimbursement criteria; pursue ongoing professional development. Other duties as assigned. Qualifications

Required Qualifications Bachelor's degree in healthcare or business-related field with two years of clinical or administrative experience in dental or medical healthcare; certification as CPC, CPMA, DANB, AHIMA, or equivalent; knowledge of third-party and federal payor insurance, coding, billing, documentation, and reimbursement. OR Associate's degree in healthcare or business-related field with four years of clinical or administrative experience in dental or medical healthcare; same certifications and knowledge as above. Preferred Qualifications

Master's degree in healthcare or business-related field (preferred). Advanced knowledge of CMS and other third-party payor coding, billing, and documentation criteria. Four or more years of clinical or administrative experience in auditing, billing, coding, and documentation across multiple specialties; five or more years in compliance auditing and monitoring; CHC certification. Knowledge of audit sampling methodologies. Knowledge, Skills & Abilities

Knowledge: Healthcare compliance concepts and CMS reimbursement principles. Skills: Strong project management, initiative, and ability to work independently. Abilities: Maintain confidentiality; define problems; collect data; present information; apply systematic problem-solving. Certifications/License

Certified coder with CPC/CPMA/DANB/AHIMA or similar from AAPC or AHIMA. Shift, Salary & Benefits

Shift: Days, M-F Pay Band: B9 Salary: Minimum $48,800 per year, commensurate with qualifications Benefits: Health and dental insurance, retirement plan, vacation, sick leave, holidays; tuition assistance for long-tenured full-time employees; other benefits as eligible. Conditions of Employment

Background check required prior to starting; credit check for positions of trust or departmental card use where applicable; motor vehicle records if driving university vehicles; verification of degree transcripts for faculty hires. Equal Employment Opportunity

Augusta University is an equal opportunity employer welcoming applicants from underrepresented groups, including individuals with disabilities and veterans. How To Apply

Visit https://www.augusta.edu/hr/jobs/ and follow the prompts for External or Internal applicants as appropriate. For assistance, contact 706-721-9365. Note: This description reflects the information provided and is refined for readability while preserving original content.

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