University of Southern California Specialist, Regulatory Compliance and Revenue Integrity - Healthcare Compliance - Full Time 8 Hour Days (Exempt) in United States
Specialist, Regulatory Compliance and Revenue Integrity - Healthcare Compliance - Full Time 8 Hour Days (Exempt)Apply Keck Medicine of USC Hospital Los Angeles, California
Has responsibility for investigating and responding to matters regarding complex coding, documentation, compliance and/or reimbursement; developing, planning and conducting comprehensive coding and/or documentation training for physicians and other staff; assisting with development and implementation of new related policies and procedures; functioning as quality assurance coordinator; conducting quality control studies of coded data and documentation to ensure compliance; participating in claims review process; overseeing design and revision of divisional billing forms; overseeing billing dictionary updates related to ICD-9 and CPT4 codes; and conducting inpatient and outpatient chart reviews. Works closely with USC Health System administrators and/or providers, as appropriate.
Minimum Education: • High School Degree or equivalent required. • Associate’s Degree in Health Information Technology or related healthcare degree; • OR Associate degree in Nursing or an accredited Registered Nurse Program as evidence by licensure or certification in any of the following: RHT, RHIA, CCS, CPC-H required. Minimum Experience/Knowledge: Required: • 3 years’ experience in a related field. • Experience working in a health setting reading and understanding clinical and hospital health records. • Candidates should satisfy at least one set of the following: • Certification in any one of the following: RHIT, RHIA, CCS, CPC-H. Intermediate Comprehensive knowledge of ICD-9-CM, CPT and HCPCS coding. Intermediate Comprehensive and coding both facility and professional services, utilizing ICD-9-CM,CPT and HCPCS. • Clinical experience as a RN or LVN in a case management or case coordinator role • with experience on patient status determinations, Interqual and documentation. • Clinical background as a RN or LVN with experience in medical auditing in an acute • care setting. • Clinical experience as a RN or LVN with expertise of case delivery documentation and related medical record documentation in an acute setting. • Knowledge of medical terminology or equivalent recent training or education. • Knowledge of auditing concepts and principles. • Basic knowledge of biology/anatomy/disease processes, laboratory test and uses, prescription medications and their respective guidelines. Preferred: • 3 years coding quality, documentation and hospital compliance experience. • Knowledge of MS-DRG grouping, APC’s and HCC’s. • Teaching/Training. • Working knowledge of inpatient admission criteria. • Working knowledge of Medicare reimbursement system and coding structures. Required License/Certification: Candidates should satisfy at least one set of the following: • RHIT, RHIA, CCS, CPC-H • RN • LVN • Fire and Safety Certification: If no card upon hire, one must be obtained within 30 days of hire, and maintained by renewal before expiration date. (Required within LA City only).
REQ20089842 Posted Date: 06/11/2020