Moffitt Cancer Center
Overview
At Moffitt Cancer Center, we strive to be the leader in understanding the complexity of cancer and applying these insights to contribute to the prevention and cure of cancer. Our diverse team of over 9,000 is dedicated to serving our patients and creating a workspace where every individual is recognized and appreciated. Moffitt has been recognized on the 2023 Forbes list of America’s Best Large Employers and America’s Best Employers for Women, Computerworld magazine’s list of 100 Best Places to Work in Information Technology, DiversityInc Top Hospitals & Health Systems, and continually named one of the Tampa Bay Times’ Top Workplace. Moffitt is a National Cancer Institute-designated Comprehensive Cancer Center based in Florida, and a leading cancer hospital in Florida and the Southeast. We are a top 10 nationally ranked cancer center by Newsweek and have been nationally ranked by U.S. News & World Report since 1999. Working at Moffitt is both a career and a mission: to contribute to the prevention and cure of cancer. Join our committed team and help shape the future we envision.
Position Compliance Professional Audit Supervisor Location: Hybrid | Tampa, FL
Position Highlights
Supervises the Compliance Professional Auditors and manages professional services audits.
Oversees the Compliance Professional Auditors in evaluating the adequacy and effectiveness of controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements to professional fee documentation, coding and billing.
Maintains and coordinates the Documentation and Coding Review Program; communicates and oversees the delivery of the Compliance Professional Auditor's audit results to the physicians, physician leadership, senior management, and staff.
Provides physician and coder education, assesses Compliance professional audits for quality assurance and makes recommendations for corrective action to leadership, faculty, coders, billers and other appropriate staff.
Acts as liaison with assigned faculty members, developing relationships and functioning as a resource to all providers and their staffs.
Serve as an institutional subject matter expert and authoritative resource on interpretation and application of documentation and coding rules and regulations, medical necessity of services delivered, and conduct enterprise risk assessments of potential and detected compliance deficiencies.
The Ideal Candidate
Strong attention to detail and analytical skills, and the ability to interpret new laws and regulations, and communicate effectively both verbally and in writing.
Understands institutional risks and appropriate judgment to use a risk-based approach in planning and executing duties.
Work in both independent contributor and team roles (both as a team leader and team member).
Excellent interpersonal and presentation skills.
Ability to effectively prioritize and execute tasks in a fast-paced, dynamic environment.
Work proactively and collaboratively to fulfill the objectives of the Compliance Program and address matters with credibility, objectivity and confidentiality in accordance with professional auditing and investigative standards.
Abide by the highest ethical standards and exhibit these standards and the Cancer Center's mission, vision, and values in the performance of position duties.
Responsibilities
Supervises the Compliance Professional Auditors.
Evaluates the appropriateness of services and procedures billed based on supporting documentation.
Prepares written reports of audit findings and recommendations and presents to appropriate stakeholders.
Conducts risk assessments to define audit priorities by evaluating previous audit findings, management priorities, coding utilization patterns, national normative data, CMS and CCI initiatives, OIG work plans and advisories and healthcare industry best practices.
Develops compliance training content and provides one on one and group training to faculty physicians, advanced practitioners, billing and coding staff and others to ensure compliance with federal and state regulations and laws, CMS and other third party payer billing rules and internal documentation, coding, and billing policies and procedures.
Researches, abstracts and communicates federal, state and payer documentation, billing and coding rules and regulations; stays current with Medicare, Medicaid and other third party rules and regulations, CPT and ICD coding updates; serves as institutional subject matter expert and authoritative resource in these areas.
Qualifications
Bachelor's degree in Health Information Management, Business, or other relevant field. In lieu of a Bachelor's Degree, a High School Diploma/GED and 4 additional years directly related work experience for a total of 9 years directly related work may be considered.
CPC or CCS-P, or other applicable AAPC or AHIMA credential.
Five (5) years' experience in Evaluation and Management coding and auditing or related work.
Knowledge of Medicare and Medicaid documentation and coding rules and guidelines; ICD/CPT/HCPCH/DRG/APC documentation coding rules; teaching physician guidelines; charge capture and reimbursement methodologies; E/M rules; medical terminology; healthcare compliance audit methodology, principles and techniques; CMS manuals; professional services reimbursement and repayment; confidentiality standards.
Ability to interpret and apply documentation and coding rules and regulations and to interpret medical records progress notes, handwritten and electronic chart entries, provider orders and other related documentation.
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Position Compliance Professional Audit Supervisor Location: Hybrid | Tampa, FL
Position Highlights
Supervises the Compliance Professional Auditors and manages professional services audits.
Oversees the Compliance Professional Auditors in evaluating the adequacy and effectiveness of controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements to professional fee documentation, coding and billing.
Maintains and coordinates the Documentation and Coding Review Program; communicates and oversees the delivery of the Compliance Professional Auditor's audit results to the physicians, physician leadership, senior management, and staff.
Provides physician and coder education, assesses Compliance professional audits for quality assurance and makes recommendations for corrective action to leadership, faculty, coders, billers and other appropriate staff.
Acts as liaison with assigned faculty members, developing relationships and functioning as a resource to all providers and their staffs.
Serve as an institutional subject matter expert and authoritative resource on interpretation and application of documentation and coding rules and regulations, medical necessity of services delivered, and conduct enterprise risk assessments of potential and detected compliance deficiencies.
The Ideal Candidate
Strong attention to detail and analytical skills, and the ability to interpret new laws and regulations, and communicate effectively both verbally and in writing.
Understands institutional risks and appropriate judgment to use a risk-based approach in planning and executing duties.
Work in both independent contributor and team roles (both as a team leader and team member).
Excellent interpersonal and presentation skills.
Ability to effectively prioritize and execute tasks in a fast-paced, dynamic environment.
Work proactively and collaboratively to fulfill the objectives of the Compliance Program and address matters with credibility, objectivity and confidentiality in accordance with professional auditing and investigative standards.
Abide by the highest ethical standards and exhibit these standards and the Cancer Center's mission, vision, and values in the performance of position duties.
Responsibilities
Supervises the Compliance Professional Auditors.
Evaluates the appropriateness of services and procedures billed based on supporting documentation.
Prepares written reports of audit findings and recommendations and presents to appropriate stakeholders.
Conducts risk assessments to define audit priorities by evaluating previous audit findings, management priorities, coding utilization patterns, national normative data, CMS and CCI initiatives, OIG work plans and advisories and healthcare industry best practices.
Develops compliance training content and provides one on one and group training to faculty physicians, advanced practitioners, billing and coding staff and others to ensure compliance with federal and state regulations and laws, CMS and other third party payer billing rules and internal documentation, coding, and billing policies and procedures.
Researches, abstracts and communicates federal, state and payer documentation, billing and coding rules and regulations; stays current with Medicare, Medicaid and other third party rules and regulations, CPT and ICD coding updates; serves as institutional subject matter expert and authoritative resource in these areas.
Qualifications
Bachelor's degree in Health Information Management, Business, or other relevant field. In lieu of a Bachelor's Degree, a High School Diploma/GED and 4 additional years directly related work experience for a total of 9 years directly related work may be considered.
CPC or CCS-P, or other applicable AAPC or AHIMA credential.
Five (5) years' experience in Evaluation and Management coding and auditing or related work.
Knowledge of Medicare and Medicaid documentation and coding rules and guidelines; ICD/CPT/HCPCH/DRG/APC documentation coding rules; teaching physician guidelines; charge capture and reimbursement methodologies; E/M rules; medical terminology; healthcare compliance audit methodology, principles and techniques; CMS manuals; professional services reimbursement and repayment; confidentiality standards.
Ability to interpret and apply documentation and coding rules and regulations and to interpret medical records progress notes, handwritten and electronic chart entries, provider orders and other related documentation.
#J-18808-Ljbffr