RCS-Quality Expert CC

RCS-Quality Expert CC

Our leaders shape strategic initiatives, develop passionate teams, and work to improve health outcomes. They advance our mission and exemplify excellence, compassion, teamwork and purpose in all that they do. Indiana University Health is seeking individuals who embody these values to join our team in the role of ROLE. 

Summary

This position exists to support Revenue Cycle Services' Total Quality Management team. This position will be responsible for performing various quality reviews, preparing and providing feedback to operational team members as well as other departments, and assisting in the development of Standard Work for team members. This position will help to ensure the accuracy and completeness of clinical medical record documentation and clinical coding as it pertains to assignment of patient status, documentation of care provided, support of billing for services provided and affect that data has on hospital reporting. This position will also be very involved in various quality initiatives across the Indiana University Health system.

Candidate Qualifications

Candidates for the position will be evaluated according to the following criteria and competencies.

• Requires RHIA, RHIT, CCS, CCS-P, CPC, CIC, or COC, or an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license., ASN required, BSN preferred (based on position/focus).
• Requires High School Diploma.
• Associate or Bachelor Degree in Health Information Management, Coding, Nursing or Finance is preferred.
• Six Sigma or Lean Six Sigma training preferred.
• Requires 5+ years? experience in revenue cycle operations in various positions related to utilization management, coding, billing, collections, payment adjustments, auditing, denial management and medical record completion.
• Requires ability to read, understand and interpret medical records and other treatment documentation.
• Requires a high level of interpersonal, problem solving, and analytic skills.
• Requires effective written and verbal communication skills in both individual and group settings to ensure professional correspondence and presentation to all levels of individuals within the organization (operational team members, leadership ? internal and external to Revenue Cycle, clinicians, physicians, auditors and other external individuals/groups).
• Requires the ability to establish and maintain collaborative working relationships with others.
• Requires ability to set and adjust defined priorities as necessary and to process multiple tasks at once.
• Requires strong attention to detail, problem solving and critical thinking skills.
• Requires ability to work with and maintain confidential information.

• Requires proficiency in the use of Microsoft Office applications (Word, Excel, PowerPoint, OneNote, Visio & Access).

   

Connect to Promise - Demonstrates a commitment to IU Health's mission, vision, and values by exhibiting behaviors and delivering results that align with the strategic direction of the organization. Ensure IU Health is working toward its vision of improving the health of all Hoosiers by providing the best care for each person as we practice our values of purpose, excellence, compassion and team.

Quality Reviews - Develops and performs on-going quality reviews on operational team members to ensure appropriate levels of quality performance are being met. Conducts individual feedback sessions with team members to discuss quality review results. Assists with continued review of areas of concern as necessary based on individuals findings. Prepares and submits formal quality reports to operational management on team members? results.

Training & Education - Assists with new team member training in preparation for their move to operations. Evaluates the educational needs of team members based upon findings, trends or as requested by leadership. Assists with the identification and development of training topics/resources for team members.

Quality Assurance and Continuous Improvement - Assists with the evaluation, coordination and completion of both internal and external quality reviews/audits within defined time-frames. Serves as a member of various committees/teams both internal and external to Revenue Cycle Services. Monitors departmental compliance with policies/procedures/guidelines/rules and provides suggestions for improvement.

Self-Improvement - Maintains expertise in relevant areas of responsibility (coding, statusing/level of care, certification/authorization, chart completion, etc.).

Communication - Able to communicate professionally, appropriately and effectively via both written and verbal methods with internal and external IU Health individuals/groups.

Special Projects - Provides support for any additional special projects as directed by leadership.

Coverage - Provides coverage in operational areas on both an as needed basis and in an effort to remain current on operational workflow and functions.

Indiana University Health is unlike any other healthcare system and we're looking for team members who share the things that matter most to us. IU Health leaders play a crucial role in advancing the mission of our organization and inspiring teams to make a meaningful difference in the lives of patients. As one of Indiana’s largest employers and the most comprehensive medical system in the state, our vision is to lead the transformation of healthcare through quality, innovation and education, and make Indiana one of the nation’s healthiest states.

IU Health is the largest health system in Indiana with nearly 40,000 team members, 15 hospitals and $8.64 billion in operating revenue. The system’s programs in cancer, cardiovascular, neuroscience, orthopedics, pediatrics and transplants have received national recognition for quality patient care.  IU Health, in partnership with the Indiana University School of Medicine, bring together highly skilled physicians, researchers, and educators into close collaboration to provide world-class care for children and adults and improve the health of patients and communities across Indiana. 

Indiana University Health is dedicated to a fair hiring process and is committed to equal opportunity and nondiscrimination for all individuals, regardless of age, color, disability, ethnicity, marital status, national origin, race, religion, gender identity, expression, sexual orientation, or veteran status.

• Indiana University Health has nearly 40,000 team members, including more than 3,600 physicians and 1,200 advanced practice providers, and we’re home to the largest nursing network in Indiana with more than 9,000 nursing team members at over 800 sites of care.
• IU Health is ranked No. 1 in Indiana by U.S. News & World Report, Riley Children's Health is ranked among the top children's hospitals in the country by U.S. News & World Report.
• A unique partnership with the Indiana University School of Medicine – one of the nation’s largest medical schools – gives patients access to groundbreaking research and innovative treatments, and it offers team members access to the latest science and the very best training – advancing healthcare for all.
• With 15 hospitals, including seven with Magnet designation and eight with Pathways to Excellence designation, our team members are leading the way through excellence.
• At Indiana University Health, your personal and professional growth is a top priority. You will have access to many diverse opportunities to learn and develop in meaningful ways that matter most to you, such as advanced clinical training, leadership development, promotion opportunities and cross training development.
• Indiana University Health is invested in the lives of Hoosiers, leading the transformation of healthcare to make Indiana one of the nation’s healthiest states.