County of Riverside
Compliance Auditor - RUHS MC
County of Riverside, Riverside, California, United States, 92504
Riverside University Health System (RUHS)
seeks a Compliance Auditor (Administrative Services Manager I), to support the health system's Corporate Compliance Department. The Compliance Auditor will be responsible for reviewing inpatient and/or outpatient records for quality and comprehensive coding.The incumbent reviews records regarding coding regulations and compliance and provides feedback and education to coders and/or physicians. The Compliance Auditor is responsible for performing annual, periodic or other focused medical record audits as requested to oversee the quality and accuracy of physician, inpatient and outpatient coding and documentation. This position requires effective communication with all RAC stakeholders and excellent organizational skills to ensure timeliness and accuracy of response requests, as well as continual program development through training and process improvement. The incumbent should have experience creating and delivering coding presentations to a variety of audiences and be comfortable communicating with physicians. This position may provide supervision to department staff.The ideal candidate for this position will possess five (5) years of experience coding inpatient and/or outpatient records in a hospital utilizing ICD-10/CPT/HCPCS and other third-party payor codes. This experience must include at least two years of lead or supervisory experience.
CPMA certification is preferred.Work Schedule:
9/80Work Address:
7898 Mission Grove Parkway, RiversideMeet the Team!
Riverside University Health System-Medical Center consistently receives national recognition for its progressive and innovative care, as well as being known as one of the top employers in the region. The 439-bed Medical Center is a designated Stroke Center, Level I Trauma Center, and the only Pediatric ICU in the region. Can you see yourself here?For more information on RUHS-Medical Center, please visit
www.ruhealth.orgFor questions regarding this recruitment contact the recruiter, Angela Levinson:
alevinson@rivco.org
/ 951-955-5562Establishes, implements and maintains a review process for coding/CDI compliance, including a formal review (audit) process. Reviews inpatient and/or outpatient coded records for quality and comprehensive coding and documentation to ensure compliance with ICD-10-CM, CPT4, and HCPCS level II coding conventions.Analyzes and interprets coding data to identify problems or trends. Ensures compliance with clinical documentation integrity, coding standards and government regulations. Maintains knowledge of coding and billing requirements and regulatory changes.Assists in the ongoing development and maintenance of coding/abstracting policies, procedures and practice standards. Audits, reports and documents all results to the Compliance officer utilizing spreadsheet/software algorithms as necessary.Provides, initiates, and supports training/education for the coding and compliance regulations to all RUHS staff as needed. Creates videos and educational modules on updates as required. Supports the education and compliance for RUHS post query, re-coding and re-billing process. Assists with organizational training and skills assessment for ICD-10-CM/PCS.Actively communicates and provides timely feedback to all coding and nursing affiliates as necessary. Ability to work independently with minimum supervision.Education:
Graduation from an accredited college or university with a bachelor's degree, preferably with a major in accounting, business or public administration, information services, finance, or a closely related field to the assignment. (Additional qualifying experience may be substituted for the required education on the basis of one year of full-time experience equaling 30 semester or 45 quarter units of the required education.)Experience:
Three years of experience in an administrative or staff capacity which must have included at least two years of experience supervising professional and technical staff in two of the following areas: gathering and compiling facts and statistics to evaluate program effectiveness and recommend program revisions; preparing and maintaining a program budget or maintaining and controlling the fiscal record keeping functions and systems in a department, agency, division, unit or company; coordinating and conducting studies of administrative and operational activities including budget preparation and control, equipment usage, staff patterns, workflow and space utilization. (Possession of a Master's degree from an accredited college or university in accounting, business or public administration, finance, or a closely related field may substitute for up to two years of the required experience on the basis of 30 semester or 45 quarter units equaling one year of full-time experience.)Preferred Experience:
The ideal candidate for this position will possess five (5) years of experience coding inpatient and/or outpatient records in a hospital utilizing ICD-9/ICD-10/CPT/HCPCS and other third-party payor codes. This experience must include at least two (2) years of lead or supervisory experience.Certifications (required):
Must possess and maintain at least
one
of the following:Certified Coding Specialist
(CCS)Certified Professional Coder
(CPC)Registered Health Information Tech/Administrator
(RHIT/RHIA)Certified Document Integrity Practitioner
(CDIP)
#J-18808-Ljbffr
seeks a Compliance Auditor (Administrative Services Manager I), to support the health system's Corporate Compliance Department. The Compliance Auditor will be responsible for reviewing inpatient and/or outpatient records for quality and comprehensive coding.The incumbent reviews records regarding coding regulations and compliance and provides feedback and education to coders and/or physicians. The Compliance Auditor is responsible for performing annual, periodic or other focused medical record audits as requested to oversee the quality and accuracy of physician, inpatient and outpatient coding and documentation. This position requires effective communication with all RAC stakeholders and excellent organizational skills to ensure timeliness and accuracy of response requests, as well as continual program development through training and process improvement. The incumbent should have experience creating and delivering coding presentations to a variety of audiences and be comfortable communicating with physicians. This position may provide supervision to department staff.The ideal candidate for this position will possess five (5) years of experience coding inpatient and/or outpatient records in a hospital utilizing ICD-10/CPT/HCPCS and other third-party payor codes. This experience must include at least two years of lead or supervisory experience.
CPMA certification is preferred.Work Schedule:
9/80Work Address:
7898 Mission Grove Parkway, RiversideMeet the Team!
Riverside University Health System-Medical Center consistently receives national recognition for its progressive and innovative care, as well as being known as one of the top employers in the region. The 439-bed Medical Center is a designated Stroke Center, Level I Trauma Center, and the only Pediatric ICU in the region. Can you see yourself here?For more information on RUHS-Medical Center, please visit
www.ruhealth.orgFor questions regarding this recruitment contact the recruiter, Angela Levinson:
alevinson@rivco.org
/ 951-955-5562Establishes, implements and maintains a review process for coding/CDI compliance, including a formal review (audit) process. Reviews inpatient and/or outpatient coded records for quality and comprehensive coding and documentation to ensure compliance with ICD-10-CM, CPT4, and HCPCS level II coding conventions.Analyzes and interprets coding data to identify problems or trends. Ensures compliance with clinical documentation integrity, coding standards and government regulations. Maintains knowledge of coding and billing requirements and regulatory changes.Assists in the ongoing development and maintenance of coding/abstracting policies, procedures and practice standards. Audits, reports and documents all results to the Compliance officer utilizing spreadsheet/software algorithms as necessary.Provides, initiates, and supports training/education for the coding and compliance regulations to all RUHS staff as needed. Creates videos and educational modules on updates as required. Supports the education and compliance for RUHS post query, re-coding and re-billing process. Assists with organizational training and skills assessment for ICD-10-CM/PCS.Actively communicates and provides timely feedback to all coding and nursing affiliates as necessary. Ability to work independently with minimum supervision.Education:
Graduation from an accredited college or university with a bachelor's degree, preferably with a major in accounting, business or public administration, information services, finance, or a closely related field to the assignment. (Additional qualifying experience may be substituted for the required education on the basis of one year of full-time experience equaling 30 semester or 45 quarter units of the required education.)Experience:
Three years of experience in an administrative or staff capacity which must have included at least two years of experience supervising professional and technical staff in two of the following areas: gathering and compiling facts and statistics to evaluate program effectiveness and recommend program revisions; preparing and maintaining a program budget or maintaining and controlling the fiscal record keeping functions and systems in a department, agency, division, unit or company; coordinating and conducting studies of administrative and operational activities including budget preparation and control, equipment usage, staff patterns, workflow and space utilization. (Possession of a Master's degree from an accredited college or university in accounting, business or public administration, finance, or a closely related field may substitute for up to two years of the required experience on the basis of 30 semester or 45 quarter units equaling one year of full-time experience.)Preferred Experience:
The ideal candidate for this position will possess five (5) years of experience coding inpatient and/or outpatient records in a hospital utilizing ICD-9/ICD-10/CPT/HCPCS and other third-party payor codes. This experience must include at least two (2) years of lead or supervisory experience.Certifications (required):
Must possess and maintain at least
one
of the following:Certified Coding Specialist
(CCS)Certified Professional Coder
(CPC)Registered Health Information Tech/Administrator
(RHIT/RHIA)Certified Document Integrity Practitioner
(CDIP)
#J-18808-Ljbffr