Director of Compliance Billing Integrity & Audit Services

Job Description Summary

Entity

Medical University Hospital Authority (MUHA)

Worker Type

Employee

Worker Sub-Type​

Regular

Cost Center

CC002278 SYS - Compliance Program

Pay Rate Type

Salary

Pay Grade

Health-35

Scheduled Weekly Hours

40

Work Shift

Job Description

The Compliance Director of Billing Integrity and Audit Services reports to the Chief Compliance and Privacy Officer for the Medical University Hospital Authority.  The Director leads a team dedicated to helping the organization ensure compliance with payment policies including but not limited to coding, billing, and documentation to support medical necessity.  The Director is responsible for executing the annual risk assessment and developing a comprehensive proactive audit plan carried out by a team of compliance auditors.  The Director oversees the external audit program, a variety of audits by third party contractors and programs including but not limited to Medicare/Medicaid Recovery Audit Contractors, Quality Improvement Organizations, CMS Comprehensive Error Rate Testing (CERT), and Palmetto GBA Targeted Probe & Education (TPE) audits. Under the director’s guidance the department remediates, or with assistance from Revenue Cycle remediates, questions and concerns related to compliance with billing, coding, and documentation.  The Director stays abreast of coding, billing, and documentation requirements, and provides education and training as well as operational assistance when applicable.

 

Additional Job Description

Education: Bachelor's Degree or Equivalent Work Experience: 9 years progressive work experience and 4 years management experience

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

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