RCS-Operational Performance Expert CC

IU Health • Indianapolis, IN

9h • Remote

About The Position

This position will be responsible for performing a range of advanced and complex
tasks that require specialized knowledge and exceptional problem-solving skills,
potentially inclusive of but not limited to quality reviews, training and
onboarding new team members, etc. This position will help to ensure
efficiencies in operational workflow, as well as 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.

Requirements

• 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.
• 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.
• Requires experience in creating and presenting coding education.
• Requires experience in coding multiple specialties, including evaluation and management services
• High School Diploma/GED is required.
• Coding/HIM Position - Requires RHIA, RHIT, CCS, CCS-P, CPC, CIC, COG or CHDA (based on position/focus). Clinical Position - Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license. BSN preferred (after 1/1/2013, ASN RN hired will be required to complete the BSN within five (5) years of hire date). Requires proficiency in the use of Microsoft Office applications (Word, Excel, PowerPoint, OneNote, Visio & Access). 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.

Nice To Haves

• Associate or Bachelor Degree in Health Information Management, Coding, Nursing or Finance is preferred.
• Six Sigma or Lean Six Sigma training preferred.

Responsibilities

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED