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Inpatient Hospital Auditor
Horizon Blue Cross Blue Shield of NJ
Job Description:
This position is responsible for conducting on site audits of hospital billing and coding practices and desk audits; forms development, profiling and tracking institutional audit trends. Performs and finalizes multiple per diem, bill verification, DRG Validation (utilization review audits) and credit balance. Additionally provides guidance/instruction to various stakeholders on ICD9- CM, DRG assignment payment and auditing. -
Travel (If Applicable): Field position 85 to 90% of time spent in the field at various facilities in NJ, PA & NY
Required Qualifications:
Knowledge:
-
Requires knowledge of medical terminology, detailed knowledge of anatomy & physiology, disease pathogenesis and treatment including procedural drug therapies, ancillary and diagnostic services.
-
Requires knowledge of principles of utilization management.
-
Requires knowledge of hospital structures and payment systems
-
Requires knowledge of centers of Medicare and Medicaid prospective payment system regulations.
-
Prefer knowledge of ACCESS Software
-
Additional licensing, certifications, registrations: - Valid Drivers license and access to a car. - RN license and CCS Certification
Preferred Qualifications:
Skills and Abilities
-
Must have effective verbal and written communication skills and demonstrate the ability to work well within a team. Demonstrated ability to deliver highly technical information to less technical individuals.
-
Must have strong PC skills experience with MICROSOFT office programs: excel, word and power point.
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Must demonstrate professional and ethical business practices, adherence to company standards, and a commitment to personal and professional development.
-
Proven time management skills are necessary. Must demonstrate the ability to manage multiple priorities [or tasks], deliver timely and accurate work products with a customer service focus, and respond with a sense of urgency as required. Demonstrated ability to work in a production focused environment.
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Proven ability to ask probing questions and obtain thorough and relevant information.
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Needs to demonstrate willingness to cross-train, and be cross-trained, in other roles/duties.
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Must be detail oriented with strong organizational and data processing skills. Proven ability to follow detailed instructions is essential, along with proven problem solving skills.
-
Proven analytical, research and problem solving skills a must.
Education Qualifications:
Requirement include:
-
Requires a Bachelor’s degree in Health Information Management or related field, or RN with CCS certification.
-
Requires a minimum of 3 years experience in a medical records department of an acute care hospital or other health care facility. Experience with DRG validation, ICD-9-CM training and education.
Instructions for Resume Submission:
Email resumes to Phyllis_R_Walker@horizonblue.com. Or Fax number 973-274-2336.
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In-Patient Coder
St. Francis Medical Center
Introduction:
St. Francis Medical Center is a teaching Medical Center established in 1874 by the Sisters of St. Francis of Philadelphia, St. Francis is sponsored by Hope Ministries and a member of Catholic Health East. We provide total healthcare - emotional and spiritual health in one convenient location.
Job Description:
Assign accurate ICD-9 diagnosis codes and ICD-9 and CPT procedure codes for inpatient medical records. Assign HCSPCS codes and modifiers as needed. Review inpatient medical record documentation to determine accurate code assignments. Performs clinical data abstracting from patient record including consultation and operative procedures, and discharge disposition. Performs accurate data entry into 3M Encoder and Abstracting software systems.
Required Qualifications:
Qualifications include:
-
Medical terminology, Anatomy and Physiology, ICD-9-CM, CPT and HCSPCS coding.
-
RHIT or CCS with 3-5 years experience preferred.
-
Must be proficient with both Inpatient and Outpatient coding.
-
Comprehensive knowledge of the APC, DRG/MS-DRG structure, Local Coverage Determinations and regulatory requirements.
-
Experience with windows based software. Good verbal and written skills.
-
Student or graduate of a Health Information program highly preferred.
Compensation/Benefits:
We offer a competitive salary and benefits package.
Instructions for Resume Submission:
Please fax or email resumes to lwashington@stfrancismedical.org
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Coding Supervisor
Southern Ocean County Hospital
Introduction:
SOCH is currently seeking a full time Coding Supervisor.
Job Description:
The coding supervisor acts as a team leader for all coding functions and activities within the hospital.
Required Qualifications:
RHIA or RHIT required and CCS preferred. Minimum of 5 years coding experience. Knowledge of government regulations and data submission requirements. Knowledge of data systems and reporting mechanisms.
Preferred Qualifications:
Administrative supervisory experience preferred.
Compensation/Benefits:
Competitive Salary with Complete Benefits package.
Instructions for Resume Submission:
Please apply online at https://soch.jobscience.com.
You may also email your resume directly to tdandrea@soch.com.
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Coding Manager
Precyse Solutions
Introduction:
Precyse Solutions is currently recruiting a Coding Manager who has the ability to travel full time. The Coding Manager will report directly into the Director, HIM Consulting Services.
Job Description:
As a Coding Manager you will:
-
Accurately examine and evaluate the medical record and health information by performing hospital inpatient, outpatient, and physician coding as well as hospital and physician audits, chart analysis, abstracting and data entry
-
Performs the functions of Coding Manager overseeing, directing, and guiding the coding staff
-
Maintains relationship with Business Office and Case Management staff
-
Responsible and accountable for coding and DRG accuracy
-
Maintains comprehensive knowledge of contemporary health record & coding practices and emerging technology to ensure that coding services and infrastructure are progressive & effective
-
Develops expertise in coding functions Leads the organization through changes to meet new industry requirements, including ICD 10
-
Responsible for coordination of meetings with ancillary departments regarding proper coding and accurate charge master items
-
Creates & manages a strong HIM culture
Required Qualifications:
Requirements of this position include:
-
Current AHIMA credential (RHIA, RHIT, CCS)
-
3 years of recent coding experience including inpatient and outpatient coding skills (DNFB - CMI Reporting Experience)
-
Minimum of 3 years management experience – supervising staff
-
Preferred coding skills: inpatient (required), ambulatory surgery, emergency room, prospective payment methodologies, charge description master review, physician office billing, evaluation and management
-
DRG Validation Experience with 3M systems
Compensation/Benefits:
Precyse Solutions offers a highly competitive compensation and benefits package, including:
-
Medical, dental, vision, 401K, PTO, holiday pay, and life insurance
-
Precyse Solutions employees can take advantage of free CE Units through Precyse University™
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A variety of assignments at many of the top health care organizations in the US
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Flexible scheduling to provide you with work-life alternatives
-
Pre-paid travel so you don’t have to use your hard-earned money, and an in-house travel agent to save you time and aggravation
Instructions for Resume Submission:
http://hire.jobvite.com/j/?aj=oeukVfwH&s=CB_Email_blast
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Ambulatory Clinical Systems Administrator - Trenton, NJ
Capital Health
Introduction
Capital Health, the largest healthcare provider in Mercer County, is a 619-bed, 2-campus, state-of-the-art healthcare system providing patient-centered care throughout Mercer County, NJ and surrounding communities. Our many unique programs, including the county’s only Level II Trauma and Level III NICU; the area’s only accredited comprehensive Stroke and Cerebrovascular Center; the area’s busiest cardiology program; a regional dialysis center; and advanced oncology care, set us apart in the minds of professionals looking to contribute to an organization that truly makes an impact.
We offer competitive compensation, outstanding benefits and a positive, team-oriented atmosphere, including:
-
Low employee expense for medical/dental
-
Opportunities at 2 hospital campuses
-
Tuition reimbursement (up to $5,000 per year)
-
Matching 403(b)
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Discounted off-site day care
-
Great access to all Central Jersey offers
Our growing health system is an easy commute from Pennsylvania via the PA Turnpike and I-95; and within New Jersey via I-95, I-195, I-295, Rt 206 and Rt 130.
Find out why our 3000+ employees have chosen Capital Health.
Equal opportunity employer
Job Description
What you’ll be doing:
-
Supporting the system implementation and customer support process for Health Information Systems Clinical EMR/EHR applications.
-
Providing project focused expertise on clinical EHR including database setup, interface configuration and oversight, user security maintenance, and clinical content build.
-
Implementing EHR modules will focus on physician electronic documentation, lab, radiology, pharmacy, document scanning and charge capture.
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Analyzing current and future user requirements, procedures, and issues to develop information system solutions to improve and support business unit operations.
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Creating Ad Hoc reports for clinical metrics for administration & clinical leadership.
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Translating reporting needs to customers.
Required Qualifications
Requirements:
-
Three years related experience in healthcare supporting the technical aspects of an ambulatory electronic medical record.
-
Associates Degree or 3-5 years experience or training.
-
Strong computer background with emphasis on information systems.
-
Must have solid understanding of and experience with SQL Database environment experience to translate reporting needs to customers.
Contact
To apply, please visit our Web site at www.capitalhealth.org and reference Job ID #1234.
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HIM Supervisor
Kindred Hospital NJ - Wayne
Introduction:
Kindred Hospital New Jersey - Wayne is a long-term acute care (LTAC) hospital. The facility is certified by Medicare and is accredited by The Joint Commission. We are a satellite facility of Kindred Hospital New Jersey - Morris County.
We offer a full range of services for stable but medically complex patients needing an extended stay in an acute care hospital. Our patients require specialized care for conditions including, but not limited to, pulmonary disease, wounds, post-op recovery and rehabilitation. Kindred’s nationwide system of long-term acute care hospitals helps us consistently enhance quality, protocols and technologies. The result of these efforts is an environment that enables each patient to reach his or her highest level of functional independence.
Job Description:
Supervises the hospital's Health Information department and assigned staff. Plans and develops medical record filing systems. Coordinates the implementation of operating policies and procedures, and participates in operational planning. May handle data storage and retrieval, abstracting, and statistical input.
Required Qualifications:
Education Qualifications:
Instructions for Resume Submission:
Please fax resume to 973.595.6432 and complete online application at www.kindredhealthcare.com
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Recovery Audit Coordinator (RAC)
Capital Health, Trenton, NJ
Introduction
Capital Health, the largest healthcare provider in Mercer County, is a 619-bed, 2-campus, state-of-the-art healthcare system providing patient-centered care throughout Mercer County, NJ and surrounding communities. Our many unique programs, including the county's only Level II Trauma and Level III NICU; the area's only accredited comprehensive Stroke and Cerebrovascular Center; the area's busiest cardiology program; a regional dialysis center; and advanced oncology care, set us apart in the minds of professionals looking to contribute to an organization that truly makes an impact.
Our growing health system is an easy commute from Pennsylvania via the PA Turnpike and I-95; and within New Jersey via I-95, I-195, I-295, Rt 206 and Rt 130.
Find out why our 3000+ employees have chosen Capital Health.
Job Description
Patient Accounts Department
Full-Time, Days
What you'll be doing:
-
Coordinating all recovery audit contractor audits and directing appeal activity relating to audit outcomes to appropriate resources.
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Auditing, examining and verifying medical records and bills and initiating corrections when necessary.
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Developing and implementing effective chargemaster review, education and training programs.
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Working with charging and billing to ensure compliance with federal and state regulations and continuous quality improvement.
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Performing compliance audits of records requested by government agencies to ensure documentation is present to support charges on patient bills.
Required Qualifications
-
Minimum 3 years hospital-based coding experience.
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Certified Coding Specialist (CCS) or Registered Health Information Technician (RHIT) required.
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Thorough knowledge of medical terminology, anatomy and physiology. Understanding of ICD-9 and CPT coding classifications.
Preferred Qualifications
Associate's degree in health information technology or healthcare administration preferred.
Education Qualifications
High school diploma/GED.
Compensation/Benefits
We offer competitive compensation, outstanding benefits and a positive, team-oriented atmosphere, including:
-
Low employee expense for medical/dental.
-
Opportunities at 2 hospital campuses.
-
Tuition reimbursement (up to $5,000 per year).
-
Matching 403(b).
-
Discounted off-site day care.
-
Great access to all Central Jersey offers.
Contact
To apply, please visit our Web site at www.capitalhealth.org
Reference Job ID #2009.
Equal opportunity employer.
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Inpatient
Coder
Robert Wood Johnson University
Hospital Hamilton
Introduction:
Whether you are talking
about employee satisfaction, patient
satisfaction, educational opportunities,
or the freedom to lead a life that is
balanced, the most important factor in
choosing a place for your skills is your
employer’s dedication to satisfaction.
Satisfaction and quality is what defines
our goals and guides our decisions. It’s
what sets our service apart.
Satisfaction is what helps us recruit
people and more important, retain them.
Quality is more than words in our
mission statement or a value we uphold.
At RWJUHH, satisfaction and quality is
everything.
Job Description:
-
Accurately assigns
diagnosis and procedure codes for
inpatient health records utilizing
ICD-9-CM classification systems.
-
Assigns DRG's and
prepares abstract utilizing
computerized coding software.
-
Abstracts relevant
clinical data from patient health
records into hospital systems as
required following UHDDS/hospital
guidelines.
-
Verifies existing
abstract data and makes changes as
needed.
-
Maintains a minimum
95% level of accuracy.
-
Follows established
coding procedures in accordance with
federal, state, and hospital
specific guidelines.
-
Regularly reviews
Coding Clinics, AHA Handbook, HQSI
mandates, and other
regulations/publication in
accordance with RWJUHH Data
Quality/Corporate Compliance
initiatives.
Required
Qualifications:
-
High School graduate
or equivalent.
-
Certificates of
completion of formal courses in
ICD-9-CM and CPT-4 coding required.
-
Two years ICD-9-CM
inpatient coding experience in an
acute care setting with thorough
knowledge of DRG's required.
-
Working knowledge of
anatomy/physiology and medical
terminology required.
Preferred
Qualifications:
Certified Coding
Specialist (CCS) or Registered Health
Information Technologist (RHIT)
preferred.
Education
Qualifications:
Certified Coding
Specialist (CCS) or Registered Health
Information Technologist (RHIT)
preferred.
Compensation/Benefits:
We feel it’s important
that we support the lifestyle of our
employees with top-of-the-line benefits
to ensure that they feel their best and
therefore, are able to provide the best
care. In addition to the supportive
network we provide, you’ll enjoy: Stable
working & learning environment
Outstanding Health Insurance Subsidized
Child Care Leading edge technology to
make your job easier
Instructions for
Resume Submission:
Interested applicants
should apply online at
www.RWJHamilton.org
Please enter the job
title: Inpatient Coder/Abstractor
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Inpatient
Coder
Princeton Healthcare System
Introduction:
Princeton HealthCare
System is a leading provider of
healthcare services. As a respected
nonprofit, community teaching system, we
offer compassionate care supported by
advanced technologies and an outstanding
medical staff. Over 97% of our
physicians have achieved board
certification, the hallmark of
professional excellence. Through our
academic and clinical affiliations with
institutions including The Children’s
Hospital of Philadelphia, we are setting
new standards in diagnostic and
treatment protocols and achieving
successful clinical outcomes for our
patients. Princeton HealthCare System is
Redefining Care through our commitment
to delivering an exceptional level of
clinical care and individualized caring
for each and every patient.
Job Description:
The Certified Coder -
Inpatient abstracts discharge data from
medical records for the purpose of
processing patient bills and compiling
statistical data including diagnostic,
procedural and physician indices.
Required
Qualifications:
Qualified candidates
will have the following:
-
Strong background in
medical terminology, disease
process, ICD-9-CM, CPT-4 coding
required.
-
Knowledge in encoder
and abstracting systems required.
-
Knowledge of DRG and
APC reimbursement methodologies
required.
-
CCS, RHIA or RHIT
eligible required.
-
Excellent
interpersonal and communication
skills required; professionalism
essential.
-
Also required are a
customer service orientation, a
teamwork approach, flexibility,
organizational and problem-solving
skills.
Instructions for
Resume Submission:
Email resume to
apirollo@princetonhcs.org OR apply
online at
www.princetonhcs.org
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Lead Coder
Holy Name Medical Center
Introduction:
We are currently seeking
a full time Lead Coder.
Job Description:
The Lead Coder will work
closely with the HIMS Coding Manager and
assist the other coders with daily
coding issues. Will work directly with
Physicians, Patient Access, Patient
Accounting and the Finance Department to
ensure compliance with all coding and
regulatory requirements.
Required
Qualifications:
-
RHIT or CCS 5 years
coding experience in an acute care
hospital.
-
Must be proficient
with both Inpatient and Outpatient
coding.
-
Good verbal and
written communication skills.
-
Comprehensive
knowledge of the APC, DRG/MS-DRG
structure, Local Coverage
Determinations and regulatory
requirements.
Preferred
Qualifications:
Experience with 3M is a
plus.
Instructions for
Resume Submission:
Please email resume to:
Kerri Klinger, RHIA
klinger@holyname.org
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Outpatient
Coder
Holy Name Medical Center
Introduction:
We are currently seeking
a full time Outpatient Medical Records
Coder.
Job Description:
This position will be
responsible for coding outpatient
surgical, ambulatory clinic and
emergency room cases.
Required
Qualifications:
CCS or CPC-H
certification required, 2-3 years
hospital coding experience - must be
able to code hospital outpatient
surgeries -Mon-Fri 8am-4:30pm, must be
willing to work overtime when needed.
Instructions for
Resume Submission:
Please email resume to:
Kerri Klinger, RHIA
klinger@holyname.org
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Manager,
Health Information Management-UMCP
Princeton Healthcare System
Introduction:
Princeton HealthCare
System is a leading provider of
healthcare services. As a respected
nonprofit, community teaching system, we
offer compassionate care supported by
advanced technologies and an outstanding
medical staff. Over 97% of our
physicians have achieved board
certification, the hallmark of
professional excellence. Through our
academic and clinical affiliations with
institutions including The Children’s
Hospital of Philadelphia, we are setting
new standards in diagnostic and
treatment protocols and achieving
successful clinical outcomes for our
patients. Princeton HealthCare System is
Redefining Care through our commitment
to delivering an exceptional level of
clinical care and individualized caring
for each and every patient.
Job Description:
Princeton HealthCare
System is currently searching for a
Manager of Health Information Management
for the University Medical Center at
Princeton. This position assists the
Director of Revenue Cycle Management in
organizing and directing the services of
the department including but not limited
to inpatient and outpatient hospital
services; rehabilitation, long term
care, and behavioral health inpatient
and outpatient.
Specific duties and
responsibilities include:
-
Direct and
coordinate all activities of the
personnel involved with daily
operational functions of the
department, to ensure analyzing,
coding, abstracting and all other
HIM activities are completed in a
timely, accurate and customer
friendly manner and in accordance
with hospital policies and
procedures.
-
Facilitate
department’s day-to-day activities
with other hospital departments
(e.g. Patient Financial Services,
Outpatient Departments, Case
Management, etc.) and physician’s
offices as required.
-
Monitor the
Discharge Not Final Billed report to
meet/exceed departmental standard
set by management. · Prepare
departmental operating budget and
monitor compliance on a monthly
basis, at minimum.
-
Assist in
development and maintenance of
specific objectives and performance
standards for each area of
responsibility
-
Direct all
activities related to recruitment of
new personnel, and the training,
scheduling, evaluation, disciplinary
action and termination of existing
personnel, assuring compliance with
personnel policies.
-
Evaluate standard of
performance of direct reporting
personnel according to policy.
-
Conduct regular
periodic staff meetings to inform
staff of changes in policies, to
provide in-service training,
facilitate open communication, and
build the team.
-
Ensure that a
current policy and procedure manual
for staff reference is maintained.
-
Evaluate progress
for each area of utilizing
quantitative productivity methods.
Implement necessary procedural and
staff revisions as considered
appropriate.
-
Support customer
service and performance improvement
goals of the department; collaborate
with other staff, within and outside
the Department, to develop means of
enhancing patient care and service.
-
In collaboration
with the Revenue Cycle Regulatory
Manager, coordinate the collection
of data for reporting purposes, such
as: HIM Dashboard/Report Card,
Performance Improvement dashboard,
Dissemination to Next Provider of
Care, Abbreviations, etc.
-
In collaboration
with the Revenue Cycle Regulatory
Manager, assist with timely review
of all regulations and standards to
assure compliance with orders or
directives issued by
governmental/regulator agencies or
third party payors. Keep informed of
all changes and coordinate
implementation within the
department.
-
Organize proper
retention of records, files and
reports in accordance with hospital
and regulatory standards.
-
Maintain standards
of confidentiality.
-
Participates in unit
compliance as related to established
standards
Required Qualifications:
Qualified candidates
will have the following:
-
Bachelor of Science
degree in Health Information
Management or equivalent experience
required.
-
Strong background in
medical terminology, disease
process, ICD-9-CM, CPT-4 coding
required.
-
Knowledge in encoder
and abstracting systems required.
-
Knowledge of DRG and
APC reimbursement methodologies
required.
-
Registered Health
Information Administrator (RHIA)
required. · Active member of AHIMA
required.
-
2 – 3 years
Supervisory experience in Health
Information Management required.
-
Computer knowledge
and data analysis/spreadsheet
proficiency preferred.
-
Excellent
interpersonal and communication
skills required; professionalism
essential. Attention to detail
necessary. Also required are a
customer service orientation, a
teamwork approach, flexibility,
organizational and problem-solving
skills.
Contact
Alisa Pirollo
Princeton HealthCare System
apirollo@princetonhcs.org
877-533-1041
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Director of
HIM
Executive HealthSearch, Inc.
Introduction
We have been retained to
fill a Director of HIM for a Hospital in
Long Island
Job Description
The incumbent will be
responsible for operations of the Health
Information Management Department.
Provide direct supervision of and
coordination of functions of two
Assistant Directors in the areas of
Medical information, Coding &
Abstracting, File Systems, Patient
Index, Chart Completion, Transcription
and Cancer Registry. The Health
Information Management Department
consists of forty employees. The
position reports to the Vice President,
Finance.
Key Challenges
-
Implementation of
Clinical Documentation Specialist
Program
-
Maintain or improve
high level of Departmental operation
and case mix.
-
Assist in
implementation of new Electronic
Medical Records System
-
Successful Joint
Commission and Cancer Registry
Surveys
-
Ensures appropriate
response letters are provided to QIO,
RAC and other 3rd Party Payer audits
in defense of Hospital billed DRGs
Key Responsibilities
-
Develops,
recommends, implements, directs and
evaluates approved strategic
operating plans.
-
Meets with
administration regularly to discuss
future planning, the status of
Department, and its problems, to
verify most logical direction in
which to proceed; recommends and
manages approved operating budget
-
Oversees daily
multi-disciplinary operations and
staff.
-
Supervises, hires,
trains, disciplines and evaluates
the performance of staff. Ensures
performance appraisals are completed
in a timely manner.
-
Ensures optimal
operational efficiency and
productivity.
-
Ensures appropriate
resources to support operations.
-
Monitors key reports
reflecting volume and departmental
performance.
-
Oversees
development, maintenance, access,
support and training pertaining to
the electronic medical record and
related applications.
-
Insures that
development and maintenance efforts
are aligned with the hospital's
strategic imperatives and clinical
documentation needs.
-
Develops and ensures
compliance with policies and
procedures pertaining to Electronic
Medical Records (EMR) and related
system access.
-
Insures that
application support and training
efforts meet the needs of users and
user departments; and interfaces as
required with EMR system vendor.
-
Oversees and tracks
response to Additional Documentation
Requests (ADR) or other Medical
Record Audits (MRA).
-
Implements and
coordinates Quality Assurance
activities and Committee functions.
-
Oversees collection
and reliability of data produced at
all levels.
-
Reports on and
oversees compliance of clinical
criteria as established by
responsible medical staff.
-
Participates in the
design and selection of forms used
in the Medical Records; determines
the sequence and format of the
content of the Medical Records; and
assures the privacy of patients and
practitioners whose records are
involved in quality assurance
activities.
-
Supervises cancer
registry staff; conducts regular
quality reviews of all staff and
provides feedback
Required Qualifications
The Director of Health
Information Management should bring a
mix of experience, talent, style and
values that will enable them to succeed
in a complex, diverse, environment and
assist in maintaining its status as a
leading healthcare provider. An ideal
candidate will also bring the following
professional experience and personal
qualities to this important role:
-
Bachelor's Degree,
required. Master's Degree preferred.
-
Health Records
Information Administrator
certification.
-
Minimum of seven (7)
years progressively responsible
experience including supervision,
electronic medical records,
information systems/ integration and
project management, preferred.
-
Capable of gathering
data and making sound, mature
decisions.
-
Highly developed
written and verbal skills.
-
Strong interpersonal
skills.
-
Must have RHIA
Education Qualifications
Compensation/Benefits
Salary is open for this
opportunity.
Contact
Adam Stern
Executive HealthSearch, Inc.
info@executivehealthsrearch.com
Phone 888-471-3244
Fax 914-920-4065
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