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Requisition Number 17-0167
Title Senior Compliance Auditor
Location UVA Research Park
City Charlottesville
State VA
Description University of Virginia Physicians Group
The University of Virginia Physicians Group (UPG) is a not-for-profit multi – specialty practice of over 1000 UVA Physicians and allied health professionals who hold dual employment between UPG and the UVA School of Medicine. UPG also provides vital administrative, billing & compliance, financial, and marketing services to the physicians of the UVA Health System. UPG is located in beautiful Charlottesville, VA within an hour of Richmond and two hours of Washington D.C. This vibrant university town offers live music, theater, museums, and is ranked one of the best places to live in America.

UPG offers a great benefit package of Health, Vision, Dental, 401(k) match plan, Flexible Spending Accounts, generous PTO, paid holidays and corporate discounts. Additional benefits at no cost to employees include a Retirement Investment Account, bonus plans, and short and long term disability insurance.

Job Description
POSITION TITLE: Compliance Audit Lead
DEPARTMENT: Compliance Audit
REPORTS TO: Director, Audit & Billing Quality

GENERAL SUMMARY: The Compliance Audit Lead is responsible for working with the Director of Audit and Billing Quality to identify compliance, financial, and operational risk, develop audit programs to assess that risk, and prepare audit reports. The Lead will also be a key communicator and liaison with Department leadership including Chairs and Billing Managers to assist and ensure billing compliance process improvements and education are effective. The Lead will serve as a mentor to the Compliance and Internal Auditors and work closely with the Director to ensure that the Audit services exceed customer expectations.

PRINCIPAL DUTIES AND RESPONSIBILITIES:
Essential functions of the job:
 Assists the Audit Director with the risk assessment, which is completed at least annually.
 Works with the Director to schedule, design and execute audits, investigations, and consulting reviews as part of the annual Compliance audit plan.
 Provides leadership and mentorship to Compliance and Internal Auditors.
 Works directly with the Director, Billing Managers, Manager of Billing Quality and Billing Quality Educators to address Compliance issues and propose practical solutions for remediation.
 Works directly with the Director on various Department Goals, Reporting, and Lean initiatives and is a reporting tools “coach” for others in Department.
 Assists in developing and implementing Audit Compliance policies and procedures to ensure the compliance audit processes and standards are documented.
 Collaborates at all levels to resolve billing and documentation issues and uses external resources and professional judgment to resolve issues that are not clearly defined.
 Presents findings and recommendations from internal and external audits to clinical departments and recommends solutions for implementing appropriate changes.
 Assists Director and Billing Quality Manager and/or clinical departments to respond to internal and external audits.
 Conducts internal reviews and provides quality review of external billing quality audits.
 Responsible for the successful completion of the bi-annual Billing Quality Audit.
 Develops and implements Clinical Documentation Improvement Programs in partnership with the clinical departments.
 Serves on various Health System committees and teams as assigned to represent the interests of the UVA Physicians Group and its healthcare providers.
 Creates and delivers presentations to clinical faculty and billing staff.
 Special projects and other duties as assigned.


Requirements REQUIRED QUALIFICATIONS (Knowledge, Skills & Abilities):
Education:
• Bachelor’s Degree and CCS-P or CPC certification or obtained within 6 months of hire or five or more years related work experience with CCS-P or CPC Certification.
 CCS-P or CPC Certification or obtained within 6 months of hire

Experience:
 Knowledge of third-party payer reimbursement, coding, and documentation requirements
 Experience in Evaluation and Management coding preferred
 Demonstrated experience in mentoring, training and teaching professionals preferred
Skills
 Demonstrated analytical and research experience
 Basic knowledge of and experience utilizing a personal computer
 Intermediate word processing, spreadsheet, presentation, and database software skills required
 Epic experience a plus

SUPERVISORY RESPONSIBILITIES: This position does not have any positions reporting to it.

WORKING CONDITIONS: General office environment

SUCCESS FACTORS:

 External (Strategic) Awareness: Having the ability to put things in context and think broadly. Involves consideration and understanding of future business needs within a changing (external) environment (social, political, economical and related industries, and technology), how process, methods, and resource requirements might be affected by future trends and developments, and developing long-term goals and strategies extending over a significant time span (i.e. 3-5 years).
 Planning and Organizing: Setting priorities and defining actions, time, and resources needed to achieve predefined goals.
 Results Orientation: Being persistent and showing perseverance on achieving concrete and tangible results out of personal responsibility; getting optimum results from situations and being ready to take action and show tenacity in case of obstacles or resistance.
 Teamwork: Working as a productive member of a cohesive group toward a common goal, and contributing to team development and effective team dynamics.
 Communications: Ability to reflect understanding of business processes and risks in verbal and written communication while acknowledging customer/client needs. Ability to produce convincing arguments and provide practical solutions based on risk and business impact. Ability to navigate complex situations and systems working with clients to produce mutually agreeable and practical solutions.
 Customer Focuses: Knowing the (internal and external) customer business needs and acting accordingly; anticipating customer needs, and giving high priority to customer satisfaction and customer service.
 Adaptability: Maintaining effectiveness in reaching set goals by adapting to changed circumstances, tasks, responsibilities, and people.
 Attention to Detail: Taking responsibility for a through and detailed method of working.


UPG is an Affirmative Action Employer
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