Apply on Employer Site

NEOGOV · 4 months ago

Healthcare Coding Compliance Auditor - RUHS MC

Riverside

Full-time

Onsite

Senior Level

$102K/yr - $140K/yr

5+ years exp

NEOGOV is seeking a skilled Coding Compliance Auditor to support the Riverside University Health System (RUHS) Compliance Department. The role involves reviewing medical records for coding accuracy, providing education to staff, and ensuring compliance with regulations.

GovTechHuman ResourcesInformation TechnologySoftware

No H1B

Responsibilities

Conduct thorough reviews of medical records for compliance with coding regulations

Provide feedback and education to coders and physicians to improve coding accuracy and documentation

Perform annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested

Communicate effectively with all RAC stakeholders, ensuring timely and accurate responses to inquiries

Support ongoing program development through training initiatives and process improvements

Deliver coding presentations to diverse audiences, including physicians

May supervise departmental staff as needed

Establishes 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 a coding/abstracting policies, procedure 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 work independently with minimum supervision

Qualification

ICD-10 codingCPT codingHCPCS codingCertified Professional Medical Auditor (CPMA)Lead/supervisory experienceOrganizational skillsCommunication skills

Required

Minimum of five (5) years' experience coding inpatient and/or outpatient hospital records using ICD-10, CPT, HCPCS, and other third-party payor codes

At least two (2) years of lead or supervisory experience

Strong organizational and communication skills, comfortable interacting with physicians and various stakeholders

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

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, work flow and space utilization

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), Certified Professional Medical Auditor (CPMA)

Preferred

Certified Professional Medical Auditor (CPMA) certification preferred

Benefits

MEDICAL/DENTAL INSURANCE: A Flexible Benefit Credit is provided on a monthly basis as governed by the Management Resolution or applicable bargaining unit. Vision coverage is provided through Vision Service Plan (VSP) at no cost to employee or eligible dependents.

MISCELLANEOUS RETIREMENT: County of Riverside has three retirement Tiers through the California Public Employees' Retirement System (CalPERS).

DEFERRED COMPENSATION: Voluntary employee contribution with a choice between two 457 deferred compensation plan options.

401(a) MONEY PURCHASE PLAN: County contribution of $50 per pay period towards choice between two 401(a) plan providers.

ANNUAL LEAVE (Bi-Weekly Accrual): 0 < 36 months = 8.92 Hours, 36 to <108 months = 10.46 Hours, 108 or more months = 12.00 Hours. Maximum Annual Leave accumulation is 1,800 hours. Employee may receive pay in lieu of up to 80 hours per calendar year.

HOLIDAYS: Normally 12 paid holidays per year.

BEREAVEMENT LEAVE: 5 days (3 days are County paid; 2 days can be taken through use of accrued leave balances).

BASIC LIFE INSURANCE: $50,000 of term life coverage. Premiums are paid by the County. Additional Supplemental Life plan is available for employee purchase.

LONG-TERM DISABILITY (LTD): Benefit pays 66.67% of earnings to a maximum of $10,000 per month; 30-day waiting period; pays to age 65. Benefit can be coordinated with other available leave balances to provide up to 100% of pay.

POST RETIREMENT MEDICAL CONTRIBUTION: A monthly contribution is made by the County towards retiree health insurance offered through the County as governed by the Management Resolution or applicable bargaining unit.