Location:Chicago, IL
Hospital:RUSH University Medical Center
Department: Medical Records
Work Type: Full Time (Total FTE between 0.9 and 1.0)
Shift: Shift 1
Work Schedule:8 Hr (7:00:00 AM - 3:30:00 PM)
Summary:The Sr Compliance Coding Analyst conducts compliance reviews on hospital and physician documentation, coding and billing in order to ensure that Rush University Medical Center is billing in accordance with federal and state regulations. The Analyst works under the direction of the Directors of Assessment and Monitoring but is expected to function at a high level of independence as to assigned projects while drawing on expertise and involvement of the Office team. The Analyst will work closely with hospital departments and Rush University Medical Group (RUMG) to analyze and resolve any coding or compliance related issues so as to minimize organizational risk. The Analyst is responsible for individual projects and team projects as needed and must be able to work independently with minimal supervision and with a high level of accuracy and attention to detail. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.
Responsibilities:1. Design and perform chart reviews, test appropriateness of billing and documentation.2. Prepare and present reports of findings with recommendations for corrective action as needed.3. Identify and prioritize risk issues, working as a team on projects.4. Monitor the Medical Center's compliance with governmental regulations through the performance of recurring compliance reviews.5. Research government billing regulations, third party payer guidelines and prospective payment system, ICD-9-CM, CPT/HCPCS coding guidelines.6. Maintain an understanding of regulatory issues through seminars, training courses and regulatory literature.7. Assist with the development of the annual departmental work plan.8. Design and implement individualized documentation and coding improvement activities for physicians and administrators.9. Act as a resource and an educator on documentation improvement projects.10. Serve as the internal liaison for Rush University Medical Center for coding and compliance questions and concerns.11. Facilitate compliance initiatives through education, newsletters and training sessions.12. Assist in the development, coordination and maintenance of all elements of the Compliance Education Program.13. Assist in updates to Compliance manuals and websites.14. Other duties and projects as assigned.
Other information:Required Job Qualifications:• High School Diploma or GED
Coding Certification required, e.g., CCS, CCS-P, RHIT, or RHIA
• Three to five years of senior level coding audit experience or five years of coding experience.• Ability to interpret and analyze electronic medical records, ancillary reports and third party payer guidelines.• Proficiency in Microsoft Office Applications.• Excellent verbal and written communication skills.• Experience with hospital billing systems.• Ability to communicate effectively with physicians and hospital department leadership.
Preferred Job Qualifications:• Bachelor's degree in Health Information Technology, Healthcare Administration, Nursing or related field.
Physical Demands:
Competencies:
Disclaimer: The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.
Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.
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