Sr Compliance Coding Analyst

Rush Hospital$72K — $118K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • High School Diploma or GED required.
  • Coding Certification (e.g., RHIA, RHIT, CCS) mandatory.
  • 3-5 years of senior-level coding audit experience or 5 years of general coding experience.
  • Proficient in interpreting electronic medical records and third-party payer guidelines.
  • Experience with hospital billing systems essential.

Responsibilities

  • Design and conduct chart reviews to assess billing accuracy.
  • Prepare and present detailed reports with corrective action recommendations.
  • Identify key risk issues and collaboratively address them.
  • Ensure compliance with governmental regulations through regular audits.
  • Research and understand various coding guidelines and payer systems.
  • Educate staff on documentation improvement initiatives.
  • Act as a liaison for coding and compliance inquiries within the medical center.

Benefits

  • Full-time position with 8-hour shifts.
  • Opportunities for professional development through educational programs.
  • Engagement with a reputable medical center recognized for quality care.
  • Chances to influence coding quality and compliance in a critical healthcare environment.
Full Job Description
Location: Chicago, Illinois

Business Unit: Rush Medical Center

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 (8:00:00 AM - 4:30:00 PM)

Pay Range: $34.89 - $56.78 per hour
Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush's anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case.

Summary:
This position is responsible for continuous monitoring of the coding quality performed by staff both within and external to the Health Information Management Department. Provides educational programs to both physicians and coding personnel to improve coding quality. Prepares various reports for administration and the Compliance Council. Represents Health Information Management and RUMC at forums that are internal and external to the medical center. Maintains a demeanor and appearance appropriate for representation of RUMC. Exemplifies the Rush mission, vision and values, and acts in accordance with Rush policies and procedures.

Other information:
Required Job Qualifications:
• High School Diploma or GED
• Coding Certification required, e.g., RHIA, RHIT and/or CCS.
• 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.
• RHIA/RHIT.

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.

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.

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