RCS-Quality Expert CC

Indiana University Health; Indianapolis (IN); On-site; USD 75,000 - 102,000; Full time

Job summary

Indiana University Health is seeking a RCS-Quality Expert CC to support the Total Quality Management team within Revenue Cycle Services. You will perform quality reviews, provide feedback to operational staff, and help develop Standard Work to improve chart completion, coding, and billing accuracy.

The role involves engaging in quality initiatives across IU Health, collaborating with multiple departments, and maintaining confidentiality.

Qualifications

• RHIA, RHIT, CCS, CCS-P, CPC, CIC, or COC, or an active Registered Nurse (RN) license in Indiana
• ASN required
• BSN preferred (based on position/focus)
• Associate or Bachelor Degree in Health Information Management, Coding, Nursing or Finance is preferred
• Six Sigma or Lean Six Sigma training preferred
• 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
• Ability to read, understand and interpret medical records and other treatment documentation
• High level of interpersonal, problem solving, and analytic skills
• Effective written and verbal communication skills to all levels within the organization
• Ability to establish and maintain collaborative working relationships
• Ability to set and adjust defined priorities and manage multiple tasks
• Strong attention to detail, problem solving and critical thinking
• Ability to work with confidential information
• Proficiency in Microsoft Office applications (Word, Excel, PowerPoint, OneNote, Visio & Access)

Responsibilities

• Plays a key role in Quality Reviews of operational team members and provides feedback
• Assists in Training & Education for new team members
• Supports Quality Assurance and Continuous Improvement initiatives across Revenue Cycle Services
• Maintains expertise in coding, statusing/level of care, certification/authorization, chart completion, etc.
• Communicates professionally with internal and external IU Health stakeholders
• Supports special projects as directed by leadership
• Provides coverage across operational areas as needed

Job description

RCS-Quality Expert CC

Overview

Our leaders shape strategic initiatives, develop passionate teams, and work to improve health outcomes. They advance our mission and exemplify excellence, compassion, teamwork and purpose in all that they do. Indiana University Health is seeking individuals who embody these values to join our team in the role of ROLE.

Summary

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.

Candidate Qualifications

• 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).

Connect to Promise

Demonstrates a commitment to IU Health's mission, vision, and values by exhibiting behaviors and delivering results that align with the strategic direction of the organization. Ensure IU Health is working toward its vision of improving the health of all Hoosiers by providing the best care for each person as we practice our values of purpose, excellence, compassion and team.

Quality Reviews

Develops and performs on-going quality reviews on operational team members to ensure appropriate levels of quality performance are being met. Conducts individual feedback sessions with team members to discuss quality review results. Assists with continued review of areas of concern as necessary based on individuals findings. Prepares and submits formal quality reports to operational management on team members? results.

Training & Education

Assists with new team member training in preparation for their move to operations. Evaluates the educational needs of team members based upon findings, trends or as requested by leadership. Assists with the identification and development of training topics/resources for team members.

Quality Assurance and Continuous Improvement

Assists with the evaluation, coordination and completion of both internal and external quality reviews/audits within defined time-frames. Serves as a member of various committees/teams both internal and external to Revenue Cycle Services. Monitors departmental compliance with policies/procedures/guidelines/rules and provides suggestions for improvement.

Self-Improvement

Maintains expertise in relevant areas of responsibility (coding, statusing/level of care, certification/authorization, chart completion, etc.).

Communication

Able to communicate professionally, appropriately and effectively via both written and verbal methods with internal and external IU Health individuals/groups.

Special Projects

Provides support for any additional special projects as directed by leadership.

Coverage

Provides coverage in operational areas on both an as needed basis and in an effort to remain current on operational workflow and functions.

Indiana University Health is unlike any other healthcare system and we're looking for team members who share the things that matter most to us. IU Health leaders play a crucial role in advancing the mission of our organization and inspiring teams to make a meaningful difference in the lives of patients. As one of Indiana’s largest employers and the most comprehensive medical system in the state, our vision is to lead the transformation of healthcare through quality, innovation and education, and make Indiana one of the nation’s healthiest states. IU Health is the largest health system in Indiana with nearly 40,000 team members, 15 hospitals and $8.64 billion in operating revenue. The system’s programs in cancer, cardiovascular, neuroscience, orthopedics, pediatrics and transplants have received national recognition for quality patient care. IU Health, in partnership with the Indiana University School of Medicine, bring together highly skilled physicians, researchers, and educators into close collaboration to provide world-class care for children and adults and improve the health of patients and communities across Indiana.

Indiana University Health is dedicated to a fair hiring process and is committed to equal opportunity and nondiscrimination for all individuals, regardless of age, color, disability, ethnicity, marital status, national origin, race, religion, gender identity, expression, sexual orientation, or veteran status.

We are an equal opportunity employer. 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.