Washington University in St. Louis
Compliance Analyst (Remote) - Billing Compliance and Audit
Washington University in St. Louis, Saint Louis, Missouri, United States, 63146
Compliance Analyst (Remote) – Billing Compliance and Audit
Washington University in St. Louis
Position Summary
The Compliance Analyst is responsible for conducting comprehensive audits of Billing Compliance within WashU Medicine’s multidisciplinary clinical practices. Audits focus on accuracy of CPT and ICD-10-CM coding, documentation, and physician/provider compliance with coding standards, government billing regulations, and University policy. The role interprets audit data and communicates findings through written reports.
Primary Duties & Responsibilities
Perform audit functions for the WashU Medicine Office of Physician Billing Compliance (OPBC).
Follow the OPBC fiscal year work plan approved by the Compliance Director.
Identify and select audit samples via Epic billing system queries and secure selected medical records.
Review medical record documentation for compliance with CPT and ICD-10-CM coding standards, University policy, and CMS regulations.
Analyze and interpret collected audit data.
Research issues arising from audit findings and update auditing tools accordingly.
Prepare and submit reports to inform physicians, departmental staff, and compliance personnel of findings.
Report non‑compliance issues to the Compliance Audit Manager.
Develop and modify auditing tools and aids to reflect regulatory changes.
Research specialty‑specific coding/billing issues and keep current on coding literature and regulatory changes.
Notify Compliance Educator(s) of practice changes that may affect compliance.
Ensure audit protocols adhere to the Standards of Ethical Coding and official coding guidelines.
Perform special audit and compliance projects as assigned.
Working Conditions
Normal office environment.
Typically seated at a desk or table.
Occasional lifting of 25–50 lbs.
Education
Associate degree or equivalent education and experience; Bachelor’s degree preferred.
Certifications
No specific certification required; preferred certifications include CPC, RHIA, RHIT, RN.
Work Experience
No specific work experience required.
Skills
Clinical experience, CMS regulations, communication, computer applications, continuous quality improvement, CPT, HIPAA, ICD-10, medical record reviews, spreadsheets, teamwork, and independent work.
Salary Range
$68,100.00 – $105,500.00 per year (Grade C13).
Benefits Statement
Up to 22 days of vacation, 10 holidays, and sick time.
Competitive health insurance packages.
Free Metro transit U‑Pass for eligible employees.
403(b) Retirement Savings Plan with university contributions.
Wellness challenges, screenings, mental health resources, and employee assistance program.
4 weeks of caregiver leave and family care resources.
Tuition coverage up to 100% for eligible employees.
EEO Statement
Washington University in St. Louis is committed to equal employment opportunity and encourages applications by individuals from underrepresented groups. The University’s policy provides equal opportunity without regard to race, ethnicity, national origin, age, religion, sex, sexual orientation, gender identity, disability, veteran status, or genetic information.
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Position Summary
The Compliance Analyst is responsible for conducting comprehensive audits of Billing Compliance within WashU Medicine’s multidisciplinary clinical practices. Audits focus on accuracy of CPT and ICD-10-CM coding, documentation, and physician/provider compliance with coding standards, government billing regulations, and University policy. The role interprets audit data and communicates findings through written reports.
Primary Duties & Responsibilities
Perform audit functions for the WashU Medicine Office of Physician Billing Compliance (OPBC).
Follow the OPBC fiscal year work plan approved by the Compliance Director.
Identify and select audit samples via Epic billing system queries and secure selected medical records.
Review medical record documentation for compliance with CPT and ICD-10-CM coding standards, University policy, and CMS regulations.
Analyze and interpret collected audit data.
Research issues arising from audit findings and update auditing tools accordingly.
Prepare and submit reports to inform physicians, departmental staff, and compliance personnel of findings.
Report non‑compliance issues to the Compliance Audit Manager.
Develop and modify auditing tools and aids to reflect regulatory changes.
Research specialty‑specific coding/billing issues and keep current on coding literature and regulatory changes.
Notify Compliance Educator(s) of practice changes that may affect compliance.
Ensure audit protocols adhere to the Standards of Ethical Coding and official coding guidelines.
Perform special audit and compliance projects as assigned.
Working Conditions
Normal office environment.
Typically seated at a desk or table.
Occasional lifting of 25–50 lbs.
Education
Associate degree or equivalent education and experience; Bachelor’s degree preferred.
Certifications
No specific certification required; preferred certifications include CPC, RHIA, RHIT, RN.
Work Experience
No specific work experience required.
Skills
Clinical experience, CMS regulations, communication, computer applications, continuous quality improvement, CPT, HIPAA, ICD-10, medical record reviews, spreadsheets, teamwork, and independent work.
Salary Range
$68,100.00 – $105,500.00 per year (Grade C13).
Benefits Statement
Up to 22 days of vacation, 10 holidays, and sick time.
Competitive health insurance packages.
Free Metro transit U‑Pass for eligible employees.
403(b) Retirement Savings Plan with university contributions.
Wellness challenges, screenings, mental health resources, and employee assistance program.
4 weeks of caregiver leave and family care resources.
Tuition coverage up to 100% for eligible employees.
EEO Statement
Washington University in St. Louis is committed to equal employment opportunity and encourages applications by individuals from underrepresented groups. The University’s policy provides equal opportunity without regard to race, ethnicity, national origin, age, religion, sex, sexual orientation, gender identity, disability, veteran status, or genetic information.
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