Our specialists provide care to Rady Children's Hospital-San Diego, a nonprofit, 551-bed pediatric-care facility dedicated to excellence in care, research and teaching. Rady Children's is the only hospital in the San Diego area dedicated exclusively to pediatric healthcare and the region's only designated pediatric trauma center. In affiliation with the University of California, San Diego School of Medicine, Rady Children's is also the region's pediatric teaching hospital. Most recently Rady Children's achieved Magnet Recognition by the American Nurses Credentialing Center (ANCC), joining only 7% of hospitals in the United States.
Must have a current CPC certification
Minimum of five (5) years of direct experience in auditing pro-fee claims
Knowledge of various coding systems utilized in healthcare (CPT, HCPCS, ICD-10)
Demonstrated in-depth knowledge and ability to conduct comprehensive and detailed audits of billing records for appropriate medical record documentation
Coding expertise with a demonstrated ability to perform concurrent or retrospective coding audits
Knowledge of coding and billing rules and regulations
Knowledge of medical terminology, anatomy and physiology
Working knowledge of the revenue cycle process, regulatory standards, and billing guidelines
Ability to analyze audit results to identify patterns, trends, variances and opportunities
Experience includes working in a collaborative environment
Excellent, fast and accurate computer skills using Microsoft Office applications (Excel, Word, PowerPoint)
Ability to quickly learn other software applications as assigned
Ability to code multi-specialty services
Proficiency in medical computer information systems and various software packages
Ability to maintain strict confidentiality
Excellent communication skills with the ability to communicate clearly both verbally and in writing and be able to articulate complex ideas for all levels of audiences
Be a self-starter who is accountable and requires minimal direction and supervision; a person who is open to new ideas; and a creative and flexible individual who is comfortable working in a large, complex organization
Possess the personal characteristics of professionalism, credibility, commitment to high standards, innovation, discriminating judgment and accountability
CPMA and/or CEMC (Required within 12-Months of Hire).
Graduation from college with a major in Healthcare, Business or Legal; an equivalent combination of education and experience may be considered.
Job ID 21