RCS-Quality Expert CC

Indiana University Health; Indianapolis (IN); Remote; USD 48,000 - 53,000; Full time

Job summary

Indiana University Health seeks a qualified professional for a quality assurance role within their Revenue Cycle Services team. This mid-senior level position involves performing quality reviews, educating staff on coding practices, and ensuring compliance with regulatory guidelines. Ideal candidates should possess relevant credentials and experience in the healthcare revenue cycle.

Qualifications

• Current coding or health information credential through AHIMA or AAPC.
• 3-5 years of coding and/or quality review experience required.
• Requires proficiency in Microsoft Office applications.

Responsibilities

• Perform quality reviews to ensure compliance with coding guidelines.
• Provide education to staff about coding and payer guidelines.
• Assist with coding questions and research as needed.

Skills

Critical thinking

Problem solving

Effective communication

Interpersonal skills

Attention to detail

Analytic skills

Education

Associate or Bachelor Degree in Health Information Management

High School Diploma

Tools

Microsoft Office

Job description

1 week ago Be among the first 25 applicants

Overview

Remote/Hybrid – Majority remote; on-site for quarterly meetings

This position exists to support Revenue Cycle Services' Total Quality Management team. This position will be responsible for performing various quality reviews, preparing and providing feedback to operational team members as well as other departments, and assisting in the development of Standard Work for team members. This position will help to ensure the accuracy and completeness of clinical medical record documentation and clinical coding as it pertains to assignment of patient status, documentation of care provided, support of billing for services provided and affect that data has on hospital reporting. This position will also be very involved in various quality initiatives across the Indiana University Health system.

Overview

Flexible M-F Remote/Hybrid – Majority remote; on-site for quarterly meetings

This position exists to support Revenue Cycle Services' Total Quality Management team. This position will be responsible for performing various quality reviews, preparing and providing feedback to operational team members as well as other departments, and assisting in the development of Standard Work for team members. This position will help to ensure the accuracy and completeness of clinical medical record documentation and clinical coding as it pertains to assignment of patient status, documentation of care provided, support of billing for services provided and affect that data has on hospital reporting. This position will also be very involved in various quality initiatives across the Indiana University Health system.

Key Responsibilities/duties Of This Role

• Performance of provider or coder quality reviews to ensure compliance with ICD-10 diagnosis coding, CPT coding including modifiers, CCI edits, other payer edits, Medicare and commercial payer policies as well as any regulatory coding guidelines across all specialties.
• Attending and providing education to physicians, APPs, coders, other leaders around results of reviews, coding, payer guidelines, etc as needed.
• Assist with any coding questions, research, etc as needed.
  
  
  

Must Haves

• Current coding or health information credential through AHIMA or AAPC.
• 3-5 years of coding and/or quality review experience with a preference of multispecialty coding of both surgical procedures as well as E/M coding.
• Knowledge of revenue cycle requirements and regulations with a preference of understanding both coding and billing, but the later is not a requirement.
• Requires critical thinking, problem solving, working well with others and strong presentation skills.
• Requires effective written and verbal communication skills in both individual and group settings.
  
  
  

Other Requirements

• Requires RHIA, RHIT, CCS, CCS-P, CPC, CIC, or COC, or an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license., ASN required, BSN preferred (based on position/focus).
• Requires High School Diploma.
• Associate or Bachelor Degree in Health Information Management, Coding, Nursing or Finance is preferred.
• Six Sigma or Lean Six Sigma training preferred.
• Requires 5+ years? experience in revenue cycle operations in various positions related to utilization management, coding, billing, collections, payment adjustments, auditing, denial management and medical record completion.
• Requires ability to read, understand and interpret medical records and other treatment documentation.
• Requires a high level of interpersonal, problem solving, and analytic skills.
• Requires effective written and verbal communication skills in both individual and group settings to ensure professional correspondence and presentation to all levels of individuals within the organization (operational team members, leadership ? internal and external to Revenue Cycle, clinicians, physicians, auditors and other external individuals/groups).
• Requires the ability to establish and maintain collaborative working relationships with others.
• Requires ability to set and adjust defined priorities as necessary and to process multiple tasks at once.
• Requires strong attention to detail, problem solving and critical thinking skills.
• Requires ability to work with and maintain confidential information.
• Requires proficiency in the use of Microsoft Office applications (Word, Excel, PowerPoint, OneNote, Visio & Access).
  
  
  

We are an equal opportunity employer and value diversity and inclusion at IU Health. IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Quality Assurance

• Industries

  Hospitals and Health Care

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