RCS-Quality Expert CC

IU Health•Indianapolis, IN

About The Position

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.

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.
Requires High School Diploma.
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).

Nice To Haves

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.

Responsibilities

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.
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.
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.
Maintains expertise in relevant areas of responsibility (coding, statusing/level of care, certification/authorization, chart completion, etc.).
Able to communicate professionally, appropriately and effectively via both written and verbal methods with internal and external IU Health individuals/groups.
Provides support for any additional special projects as directed by leadership.
Provides coverage in operational areas on both an as needed basis and in an effort to remain current on operational workflow and functions.