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Compliance Audit Specialist

Job Description


Job ID: 1208588
Employment Status: Full-Time
More Information:

BJC Behavioral Health is a community health center that provides and coordinates behavioral health services for more than 6,000 seriously mentally ill adults and seriously emotionally disturbed children in St. Louis City, St. Louis County, St. François, Iron and Washington counties.  As an Administrative Agent of the Missouri Department of Mental Health (DMH) serves as a major point of entry for people eligible for mental health services funded by DMH and is responsible for serving as gatekeeper to the public mental health system.  BJC Behavioral Health also administers the BJC Employee Assistance Program ad Behavioral Health Partners, an administrative services organization.

Ensures that clients receive quality behavioral health care. The program evaluates providers and monitors: quality of care, efficiency of care, client satisfaction and compliance and clinical standards.


Overview


Role Purpose

Perform insurance billing and process audits and assists with special projects. Serve as a regulatory consultant and resource to management and departments at all levels and assist in developing appropriate action plans. Requires a high degree of analytical skills, the ability to work independently, the ability to maintain confidentiality and to be a catalyst for change.


Responsibilities

  • Performs detailed compliance, process and insurance billing audits in the hospital and outpatient facilities.
  • Prepares audit work papers to document billing exceptions or patient care documentation issues.
  • Identifies problems or critical issues in billing and patient care documentation.
  • Assists with the identification of problems, analysis of problems and development of solutions.
  • Assists in the preparation of formal written reports which detail audit findings and recommendations.

  • Minimum Requirements

     

    Degree

  • Associate's Degree
  •  

    Experience

  • 2-5 years
  •  

    Supervisor Experience

  • No Experience

  •  

    Preferred Requirements and Additional Job Information

     

    Licenses & Certifications

  • RN
  • RHIA/RHIT/CCS

  • Benefits Statement

    Note: not all benefits apply to all openings

    -  Comprehensive medical, dental, life insurance, and disability plan options
    -  Pension Plan*/403(b) Plan
    -  401(k) plan
    -  Tuition Assistance
    -  Health Care and Dependent Care Reimbursement Accounts
    -  On-Site Fitness Center (depending on location)
    -  Paid Time Off Program for vacation, holiday and sick time

    *Pension does not apply to Memorial Hospital, Memorial Hospital East, Alton Memorial or Parkland Health Center


    Legal Statement

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.

     

    Equal Opportunity Employer