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Audit and Billing Compliance Specialist
University of Arkansas System. Review revenue against third-party billing guidelines .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in revenue cycle management, clinical billing practices, and charge capture processes. Proficient in auditing, appeals, and collaboration with clinical departments to ensure compliance and accuracy in billing documentation.
Highest-signal resume keywords
Revenue Cycle ManagementClinical Billing PracticesCharge CaptureRN CertificationData Manipulation in Excel
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
AuditingCharge CaptureClinical AppealsBilling DocumentationRevenue Cycle UnderstandingHospital Coding KnowledgeData AnalysisClaims ManagementClinical Oversight
Soft Skills
Strong Written CommunicationAttention to DetailCollaboration with Physicians
Tools & Technologies
EPICExcel
Certifications & Qualifications
RNCCSCCS-PCPCCPMACEMC
Industry Keywords
Third-Party Billing GuidelinesRevenue GuardianClinical PracticesOutpatient ServicesInpatient Appeals
About the role
Key responsibilities & impact- Review revenue against third-party billing guidelines
- Provide clinical expertise on charging and clinical practices
- Ensure accuracy and integrity of billing documentation
- Guide HBS staff regarding charging and clinical practices
- Liaise with clinical departments on charging issues and clean claims generation
- Support charge capture for global and research accounts
- Complete or support clinical appeals for outpatient services and occasionally inpatient appeals
- Perform audits as needed
- Investigate denial reasons and determine appropriate appeals
- Provide documentation to support appeals
- Resolve billing requirements involving clinical expertise and third-party inquiries
- Provide high-level clinical oversight and expertise to staff
- Collaborate with leadership, department directors, and physicians to improve revenue cycle processes
- Monitor operational and financial performance and drive process improvements
- Oversee hospital billing guidelines and charges posted by operations
- Resolve Revenue Guardian edits within EPIC and answer charge-related questions
- Complete daily bills holding for charge capture issues and assigned Revenue Guardian work queues
- Evaluate research accounts and determine appropriate charging within five business days
- Address missing or complex documentation with clinical departments
- Identify charging patterns and notify departments or management
- Work assigned claim edit work queues daily
- Perform charge audits and assess external audits
Requirements
What you’ll need- Bachelor’s degree plus 3 years’ experience in nursing, or coding/auditing functions OR High School diploma plus 7 years’ experience in nursing, or professional coding/auditing functions
- Must have current RN, CCS, CCS-P or CPC certification
- Understanding of the revenue cycle
- Demonstrated ability to present information verbally
- Strong written communication skills with attention to detail
- Demonstrated ability to work with physicians
- Ability to work in and manipulate data successfully in EXCEL
- Pre-employment screening, including criminal background, drug testing, and/or education verification
- Proof of legal authority to work in the United States on the first day of employment
- Three professional references and resume required
- BSN, ADN, CPC, or CCS preferred
- One year of case management, coding, charge capture, auditing, or hospital billing preferred
- Hospital coding knowledge preferred
- CPMA or CEMC certification preferred
Benefits
Comp & perks- Medical, Dental and Vision plans available for qualifying staff and family
- Holiday, Vacation and Sick Leave
- Education discount for staff and dependents (undergraduate only)
- Up to 10% matched contribution from UAMS
- Basic Life Insurance up to $50,000
- Career Training and Educational Opportunities
- Merchant Discounts
- Concierge prescription delivery on the main campus when using UAMS pharmacy