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The Lead Physician Billing Compliance Analyst performs physician coding and documentation audits to ensure compliance with regulatory requirements and payer policies. They also supervise staff, conduct remedial training, and act as a liaison between the manager and the Office of Compliance.
Candidates must have at least 5 years of medical coding experience and 2 years of medical billing experience, along with supervisory or project management experience. Professional certification such as CCS, CCS-P, CPC, or CPMA is required at the time of hire.
Job Duties
Under limited supervision, the Lead Physician Billing Compliance Analyst (Lead) will perform physician
coding/documentation reviews for providers of the University of Florida Jacksonville Physicians Group (UFJPI). Audit focus
will be on physician/non-physician practitioner coding and chart documentation to include review of E&M, CPT-4, ICD-10,
Level II HCPCs, Teaching Physician guidelines and carrier specific policies. The Lead will prepare and present accurate
reports of audit findings to appropriate personnel. The Lead will coordinate with various UFJPI representatives to ensure
that any resulting refunds are processed and educational needs are addressed. The Lead will assist the Manager with
monitoring and recording of productivity and quality of staff and will train staff on job duties and work flow processes. The
Lead will ensure all job duties are covered when personnel are on vacation or ill. The Lead will handle routine personnel
issues and act as the liaison between the Manager and Office of Compliance (OOC) staff.
Essential Functions
• Perform audit reviews of medical providers of the UFJPI within designated timeframes.
• Identify ongoing problems in audit process and notify manager when issues surface.
• Audit chart documentation for accurate coding and to verify that chart documentation supports services billed.
• Audit chart documentation for compliance with E&M, CPT procedure coding, ICD-10-CM diagnosis coding, Teaching Physician guidelines, payer specific polices and regulatory requirements.
• Prepare accurate audit reports that include summary spreadsheets of audit findings.
• Perform analysis of audit findings and summarize by individual records for placement in the OOC central database. Present audit results to appropriate faculty and billing personnel.
• Identify remedial training needs through audit process and if necessary conduct remedial training with provider or billing staff.
• Identify, locate and obtain medical record documentation necessary to accurately complete audits.
• Perform quality assessments on work product of Analysts and Research Assistants in accordance with departmental policies and procedures.
• Assist in the development of policies and procedures to ensure work is performed and completed in accordance with the University of Florida College of Medicine Billing Compliance Plan
• All other duties as assigned
• Travel up to 10%
Experience Requirements
2 years Medical billing required
5 years Medical coding (procedural and diagnosis) for multi-specialty providers required
4 years Medicare, Medicaid, and Tricare payment and reimbursement rules required
4 years Medical record chart auditing for professional billing required
1 year Supervisory or project management required
1 year medical management information systems (EPIC preferred) required
1 year Auditing software applications (e.g MDaudit, Compliance Risk Analyzer) preferred
Education
High School Diploma or GED equivalent required
Associates Business or Health care related field preferred
Certificate/Licensure
Certified Coding Specialist required or at time of hire
Certified Coding Specialist - Physician Based
(CCS-P) - AHIMA
required or at time of hire
Certified Professional Coder (CPC) required or at time of hire
Certified Professional Medical Auditor (CPMA) required at time of hire
UFJPI is an Equal Opportunity Employer and Drug Free Workplace
World-class academic health center in Florida.
University of Florida Health is a world-class academic health center in Florida, encompassing hospitals, physician practices, colleges, centers, institutes, programs and services across northeast and north-central Florida. UF Health represents the shared vision and commitment to patient care excellence of more than 22,000 employees of the University of Florida Health Science Center and UF Health Shands health care system.
Offices: 1600 SW Archer Rd, Gainesville, FL 32608, US · 1515 SW Archer Road, Gainesville, FL 32608, US · 1600 SW Archer Road, Gainesville, FL 32608, US · 655 West 8th Street, Jacksonville, FL 32209, US
Based on 1752 listings with disclosed salaries, most administrative jobs in Florida pay between $45k–$90k per year. Individual offers vary with seniority, company size, and specialization.
There are currently 16,401 open administrative positions in Florida listed on Clera. New openings are added daily as companies post roles.
Companies currently hiring include Florida Department of Agriculture and Consumer Services, University of Miami Health System-Uhealth, UF Health, University of Miami Health System, Orlando Health, among others. Browse the listings above to see every active employer.
Yes — 1941 of the 16401 open administrative positions offer remote or hybrid work (721 remote, 1220 hybrid).
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.
