Revenue Cycle Coding Auditor/Trainer (5032)

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Description

The Revenue Cycle Coding Auditor will perform reviews for employees in the Coding department. Audits will include, but are not limited to; employee productivity and quality based on proper documentation, accuracy and coding guidelines. The Auditor will also provide feedback and support relating to departmental/role specific productivity and quality expectations. The incumbent for this position will utilize a high level of in-depth knowledge of the coding role to perform all audits based on specific departmental need.

*****On-Site Only**** Examples of Duties

PBS Auditor: 100%

• Conduct quality and productivity reviews of coding staff using structured and consistent review programs and methods.
• Demonstrate in-depth knowledge and experience with SIU-HC supported applications, including but not limited to Athena IDX, TouchWorks, Epic, Cerner and Precision BI
• Must possess the ability to understand the integration of applications and their impact on business processes and operations.
• Provide on-site guidance and assistance to end users as necessary.
• Review, develop and update timely review and feedback methods and materials
• Maintain effective communication with end users to understand problems and adequately troubleshoot issues.
• Perform needs assessments and monitor compliance to ensure transfer of learning and improvement
• Must possess the ability to maintain confidentiality
• Analyze and interpret complex data sets to support strategic decision-making and performance improvement initiatives.
• Independently conduct research and prepare detailed reports with minimal supervision.
• Acquire and apply knowledge of FQHC (Federally Qualified Health Center), federal, and state healthcare reimbursement guidelines to ensure compliance.
• Identify trends and performance issues through data analysis and formulate actionable recommendations for improvement.
• Support leadership by preparing presentations and data summaries to communicate program effectiveness and progress toward goals.
• Provides and/or arrange for training of coding staff and medical specialties.
• Attend meetings with coders/management
• Work with compliance for trends in billing and coding
• Maintain Coding Certification

Qualifications

MINIMUM QUALIFICATIONS
1. High school graduate or equivalent
2. Any one or any combination totaling one (1) year (12 months) from the following categories:

a. College coursework which includes Information Technology (IT), IT Management, Programming, IT systems, Management, Finance, Business or a closely related discipline, as measured by the following conversion table or its proportional equivalent: i. 30 semester hours equals one (1) year (12 months) ii. Associate's Degree (60 semester hours) equals eighteen months (18 months) iii. 90 semester hours equals two (2) years (24 months) iv. Bachelor's Degree (120 semester hours) equals three (3) years (36 months) b. Work experience in IT-related functions such as hardware/software support, programming, network design, network engineering, IT systems integration, or closely related field including progressively more responsible work experience in a training, quality analyst, or leadership capacity 3. Two (2) years of progressively responsible experience in patient revenue cycle including, but not limited to: patient registration, eligibility verification, scheduling, referrals, and authorizations, claims billing, insurance follow up (government and non-government), denial management, coding, cash management, payment posting, customer service, and collections.
4. Two (2) years of work experience with programs such as Epic, Athena, IDX, or Centricity Business (CB) NOTE: Experience in 3 - 4 above can run concurrently 5. Current certification as a Certified Coding Specialist (CCS) or Certified Coding Specialist-Physician-based (CCS-P) or Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) by the American Health Information Management Association (AHIMA), or current certification as a Certified Professional Coder (CPC) or a Certified Outpatient Coder (COC) by the American Academy of Professional Coders (AAPC) (formerly CPC-H certification).

Condition of Employment

Out of State Applicants that apply to Springfield vacancies in classifications in the occupational area of Professional, Semi-Professional, or Managerial will be subject to the following Condition of Employment: Pursuant to the State University Civil Service System, an out-of-state resident who is hired into this position must establish Illinois residency within 180 calendar days of their start date.

Supplemental Information

If you require assistance, please contact the Office of Human Resources at View email address on click.appcast.io or call View phone number on click.appcast.io Monday through Friday, 8:00am-4:30pm.

The mission of Southern Illinois University School of Medicine is to optimize the health of the people of central and southern Illinois through education, patient care, research and service to the community.

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Southern Illinois University School of Medicine is an Affirmative Action/Equal Opportunity employer who provides equal employment and educational opportunities for all qualified persons without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, protected veteran status or marital status in accordance with local, state and federal law.

Pre-employment background screenings required.