What are the responsibilities and job description for the Revenue Compliance Auditor / Educator position at Yale New Haven Health?
Overview
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
To assist in the planing, organizing, and completion of auditing activities required to comply with federal guidelines and other compliance-related requirements. To identify lost revenue opportunities and any overpayments made due to errors in coding, insufficient medical record documentation, etc. To increase and strengthen health care providers' awareness and understanding of medical record documentation guidelines and coding principles. Serves as a role model for ethical management behavior and promotes an awareness and understanding of the System's Code of Conduct and Privacy and Corporate Compliance Program.Assists the Manager, System Revenue Integrity in assessing risk and developing an auditing plan to support the overall compliance plan. Interacts with all levels of management within the Health System.
EEO/AA/Disability/Veteran
Responsibilities
Qualifications
YNHHS Requisition ID
145841
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
To assist in the planing, organizing, and completion of auditing activities required to comply with federal guidelines and other compliance-related requirements. To identify lost revenue opportunities and any overpayments made due to errors in coding, insufficient medical record documentation, etc. To increase and strengthen health care providers' awareness and understanding of medical record documentation guidelines and coding principles. Serves as a role model for ethical management behavior and promotes an awareness and understanding of the System's Code of Conduct and Privacy and Corporate Compliance Program.Assists the Manager, System Revenue Integrity in assessing risk and developing an auditing plan to support the overall compliance plan. Interacts with all levels of management within the Health System.
EEO/AA/Disability/Veteran
Responsibilities
- 1. Essential Functions:
- 1.1 Under the direction of the Manager, System Revenue Integrity, assists in the performance of risk analysis to identify areas with greatest potential for non-compliance with governmental and internal requirements.
- 2. Secondary Functions:
- 2.1 Attends meetings and serves on committees.
Qualifications
EDUCATION
Bachelor's degree in a relevant field, required.
EXPERIENCE
Minimum of five (5) years' experience in a healthcare setting with experience performing medical record audits for clinical documentation, charge and reimbursement accuracy. Understanding of anatomy, terminology, and physiology with experience in hospital and provider coding with CPT and ICD-9/ICD-10. CCS, CCS-P, CPC, CPC-H, RHIA or RHIT is required. Knowledge of health care management in terms of financial and billing concepts. Knowledge of health care reimbursement and managed care issues.
LICENSURE
CCS, CCS-P, CPC, CPC-H, RHIA or RHIT is required
SPECIAL SKILLS
Must be proficient in Microsoft Word, and Excel.
YNHHS Requisition ID
145841
