This position will consult with designated service areas within Vanderbilt University Medical Center (VUMC) as they respond to questions and evolve processes, and partner with technical functions, such as contracting personnel, billing managers, medical coders to establish best practices and develop and maintain practice pathways to adhere to policy. Will also perform directed audits and recurring monitoring consistent with Compliance Audit work plans and processes. These audits will be designed to assess adherence to VUMC policy and increase understanding of best practices and foster a reduction in performance variance.
The ideal candidate will have the following essential qualifications:
Must be experienced in the review and monitoring of health care systems and processes relating to documentation, coding, billing and contracting.
Clinical degree or experience in compliance related disciplines preferred
Strong computer skills with competency in Microsoft Word, Access and Excel
Familiarity with using technology to extract data and reports from internal and external databases to perform benchmark analyses and identify potential outliers and anomalies
Familiarity with electronic medical records systems, MGMA data, UHC data and/or VUMC Business Objects reporting preferred
Industry and content expertise in integrated billing compliance, regulatory affairs, privacy/security, audit, and business/physician transaction regulatory compliance
Experience with process and/or quality improvement initiatives preferred
Demonstrated experience in internal audit principles and practices
Knowledge of federal regulations, healthcare program billing requirements and privacy/security standards. Proven record of successful experience in the application of these mandates in a multi-functional, multi-disciplinary setting
Competence in preparing and presenting audit results to individuals at a variety of levels from various constituencies within the organization.
Vanderbilt University Medical Center is a comprehensive health care facility dedicated to patient care, research, and biomedical education. Our reputation for excellence in these areas has made us a major center for patient referrals from throughout the Mid-South. Each year, people throughout Tennessee and the Southeast choose Vanderbilt University Medical Center for their health care because of o...ur leadership in medical science and our dedication to treating patients with dignity and compassion.The mission of Vanderbilt University Medical Center is to advance health and wellness through preeminent programs in patient care, education, and research.