Has responsibility for investigating and responding to matters regarding complex coding, documentation, compliance and/or reimbursement; developing, planning and conducting comprehensive coding and/or documentation training for physicians and other staff; assisting with development and implementation of new related policies and procedures; functioning as quality assurance coordinator; conducting quality control studies of coded data and documentation to ensure compliance; participating in claims review process; overseeing design and revision of divisional billing forms; overseeing billing dictionary updates related to ICD-9 and CPT4 codes; and conducting inpatient and outpatient chart reviews.Works closely with USC Health System administrators and/or providers, as appropriate.
Minimum Education:â¢High School Degree or equivalent required.â¢Associateâs Degree in Health Information Technology or related healthcare degree; â¢OR Associate degree in Nursing or an accredited Registered Nurse Program as evidence by licensure or certification in any of the following: RHT, RHIA, CCS, CPC-H required. Minimum Experience/Knowledge:Required:â¢3 yearsâ experience in a related field.â¢Experience working in a health setting reading and understanding clinical and hospital health records. â¢Candidates should satisfy at least one set of the following: â¢Certification in any one of the following: RHIT, RHIA, CCS, CPC-H. Intermediate Comprehensive knowledge of ICD-9-CM, CPT and HCPCS coding. Intermediate Comprehensive and coding both facility and professional services, utilizing ICD-9-CM,CPT and HCPCS.â¢Clinical experience as a RN or LVN in a case management or case coordinator roleâ¢with experience on patient status determinations, Interqual and documentation.â¢Clinical background as a RN or LVN with experience in medical auditing in an acuteâ¢care setting.â¢Clinical experience as a RN or LVN with expertise of case delivery documentation and related medical record documentation in an acute setting.â¢Knowledge of medical terminology or equivalent recent training or education. â¢Knowledge of auditing concepts and principles.â¢Basic knowledge of biology/anatomy/disease processes, laboratory test and uses, prescription medications and their respective guidelines. Preferred: â¢3 years coding quality, documentation and hospital compliance experience.â¢Knowledge of MS-DRG grouping, APCâs and HCCâs. â¢Teaching/Training. â¢Working knowledge of inpatient admission criteria. â¢Working knowledge of Medicare reimbursement system and coding structures.Required License/Certification:Candidates should satisfy at least one set of the following:â¢RHIT, RHIA, CCS, CPC-Hâ¢RNâ¢LVNâ¢Fire and Safety Certification: If no card upon hire, one must be obtained within 30 days of hire, and maintained by renewal before expiration date. (Required within LA City only).
USC is the leading private research university in Los Angeles—a global center for arts, technology and international business. With more than 47,500 students, we are located primarily in Los Angeles but also in various US and global satellite locations. As the largest private employer in Los Angeles, responsible for $8 billion annually in economic activity in the region, we offer the opportunity to work in a dynamic and diverse environment, in careers that span a broad spectrum of talents and skills across a variety of academic and professional schools and administrative units. As a USC employee and member of the Trojan Family—the faculty, staff, students, and alumni who make USC a great place to work—you will enjoy excellent benefits, including a variety of well-being programs designed to help individuals achieve work-life balance.