Summary: Assists thevice-president in carrying out the responsibilities of the Internal Auditfunction. Conducts auditing and monitoring on physicians' billing activities toassure accuracy and compliance within Cook Children's Health Care Systempolicies, government regulations and third-party payor contracts. Consults withphysicians, CCPN administration, and CCHCS employees on Medicare, Medicaid andother payer requirements as requested.
Registered Health Information Administrator (RHIA), RegisteredHealth Information Technician (RHIT) or Certified Coding Specialist-Physician(CCS-P) required.
An Associate's Degree is required with a Bachelor's degreebeing preferred.
This position requires a minimum of five years in an acutecare setting, physician office setting and outpatient setting.
2 years of additional experience can be used in lieu of theAssociate's degree requirement.
Expert knowledge of ICD-9-CM, CPT, HCPCS, DRG, and APCcoding systems.
Computer literacy, effective teaching skills and excellentinterpersonal, problem-solving and verbal/written communications skillsrequired.
Extensive auditing experience in health care settingrequired.
Current knowledge with reimbursement issues as it pertainsto Medicare, Medicaid, and third-party payers.
Training in anatomy and physiology, pathology and medicalterminology required.
Pediatric experience is highly desirable.
A coding proficiency test required through on-site testing.