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Provider Quality Reviewer and Educator

Provider Quality Reviewer and Educator

at Indiana University-Bloomington

Posted: 1-22-2025

Remote

Healthcare

Ï

$46,520/year

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About this Career

Medical Records Specialists

Skills

Six Sigma Methodology, Auditing, Research, Management, Medical Records, Microsoft OneNote, Microsoft Access, Revenue Cycle Management, Certified Coding Specialist - Physician-Based (CCS-P), Certified Health Data Analyst (CHDA), Utilization Management, Microsoft PowerPoint, Finance, Nursing, Nurse Licensure Compact, Registered Health Information Administrator (RHIA), Leadership, Medicare, Collections, Lean Six Sigma, Billing, CPT Coding, Critical Thinking, Microsoft Visio, Operations, Registered Health Information Technician (RHIT), Detail Oriented, Health Information Management, Microsoft Excel, Verbal Communication Skills, Microsoft Office, Problem Solving, Surgical Procedures, ICD Coding (ICD-9/ICD-10), Presentations, Certified Coding Specialist (CCS)

Job Description

Provider Quality Reviewer and Educator 3.7 3.7 out of 5 stars Indianapolis, IN 46219 • Hybrid work Provider Quality Reviewer and Educator Job Description Overview Position is Remote/Hybrid - Majority remote; on-site for quarterly meetings. Hours are Monday-Friday with flexible hours This position will be responsible for: Performance of provider quality reviews to ensure compliance with ICD-10 diagnosis coding, CPT coding including modifiers, CCI edits, other payer edits, Medicare and commercial payer policies as well as any regulatory coding guidelines across all specialties. Attending and providing education to physicians, APPs, other leaders around results of reviews, coding, payer guidelines, etc as needed. Assist with any coding questions, research, etc as needed. Must have the following to be considered: Current coding or health information credential through AHIMA or
AAPC. 3-5
years of coding and/or quality review experience with a preference of multispecialty coding of both surgical procedures as well as E/M coding. Knowledge of revenue cycle requirements and regulations with a preference of understanding both coding and billing, but the later is not a requirement. Requires critical thinking, problem solving, working well with others and strong presentation skills. Requires effective written and verbal communication skills in both individual and group settings. High School Diploma/GED is required. Associate or Bachelor Degree in Health Information Management, Coding, Nursing or Finance is preferred. Coding/HIM Position - Requires RHIA, RHIT, CCS, CCS-P, CPC, CIC, COG or CHDA (based on position/focus). Clinical Position - Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license. BSN preferred (after 1/1/2013, ASN RN hired will be required to complete the BSN within five (5) years of hire date). Requires proficiency in the use of Microsoft Office applications (Word, Excel, PowerPoint, OneNote, Visio & Access). 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. Six Sigma or Lean Six Sigma training preferred. We are an equal opportunity employer and value diversity and inclusion at IU Health. IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation. Indiana University Health is Indiana's most comprehensive health system, with 15 hospitals and nearly 40,000 team members serving Hoosiers across the state. Our partnership with the Indiana University School of Medicine gives our team members access to the very latest science and the very best training, advancing care for all. We're looking for team members who share the things that matter most to us. People who are inspired by challenging and meaningful work for the good of every patient. People who are compassionate and serve with a purpose. People who aspire to excellence every day. People who are always ready to apply themselves.

Other Job Posting Details

Salary

Minimum

Maximum

$35,550/yr

$67,830/yr

MINIMUM EDUCATION LEVEL

High school or GED

MINIMUM YEARS EXPERIENCE

5