Indiana University 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, brings 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. IU Health is invested in the lives of Hoosiers, leading the transformation of healthcare to make Indiana one of the nation’s healthiest states. As an employee of Indiana’s most comprehensive health system, we are excited to support team members who are inspired by challenging and meaningful work for the good of every patient.
Operational Performance Expert CC
Location
United States
Posted
17 hours ago
Salary
Not specified
No structured requirement data.
Job Description
Role Description
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.
- 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.
Qualifications
- 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.
Requirements
- High School Diploma/GED is required.
- Associate or Bachelor Degree in Health Information Management, Coding, Nursing or Finance is preferred.
- 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.
- Six Sigma or Lean Six Sigma training preferred.
Benefits
- Access to many diverse opportunities to learn and develop in meaningful ways that matter most to you, such as advanced clinical training, leadership development, promotion opportunities and cross training development.
Job 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.
- Associate or Bachelor Degree in Health Information Management, Coding, Nursing or Finance is preferred.
- 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.
- Six Sigma or Lean Six Sigma training preferred.
Benefits
- Access to many diverse opportunities to learn and develop in meaningful ways that matter most to you, such as advanced clinical training, leadership development, promotion opportunities and cross training development.