PHNS is currently looking for a Revenue Integrity Audit Specialist. Under minimal supervision and according to established policies and procedures, the Revenue Integrity Audit Specialist conducts coding quality review audits in compliance with the coding compliance plan and established standards. Supports the review activities that drive hospital revenue including revenue cycle initiatives, internal audit plan, reimbursement audits (RACs, MPRO) and data quality. Key support for the coding areas and staff.
· Five plus years of professional level experience in coding and/or reimbursement
· Certification as a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT)
· Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) preferred
· Analytical ability to gather and interpret data, to evaluate reports and track progress of initiatives and to determine methods for ensuring revenue integrity and coding compliance
· High degree of interpersonal skills to effectively communicate with internal and external customers, including physicians, clinicians, management and coding staff
· In-depth technical knowledge of ICD-9-CM, CPT-4 coding conventions, DRG and APC assignment, medical terminology and anatomy
· Advanced knowledge of coding/documentation and billing regulations related to Medicare, Medicaid and commercial insurance
· Experience in computerized encoding and abstracting in a Windows-based environment preferred
· Computer skills for organizing and displaying data, accessing various internal applications and external resources via the Internet
· Conflict resolution, discretion, diplomacy, tact and listening skills
· Leadership skills such as accountability, decision-making, coaching and counseling
· Ability to work independently with minimal supervision
Anthelio - 13 months ago
Anthelio is the largest independent provider of "Information Technology" and "Business Process" services to hospitals,...