Healthcare Coding Compliance Auditor - RUHS MC (Finance)

Riverside University Health System (RUHS) is seeking a skilled Coding Compliance Auditor (Administrative Services Manager I) to support the Compliance Department. The Compliance Auditor will review inpatient and outpatient medical records to ensure quality, accuracy, and comprehensive coding in accordance with regulations.
Key Responsibilities:

• Conduct thorough reviews of medical records for compliance with coding regulations
• Provide feedback and education to coders and physicians to improve coding accuracy and documentation
• Perform annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested
• Communicate effectively with all RAC stakeholders, ensuring timely and accurate responses to inquiries
• Support ongoing program development through training initiatives and process improvements
• Deliver coding presentations to diverse audiences, including physicians
• May supervise departmental staff as needed

Qualifications:

• Minimum of five (5) years' experience coding inpatient and/or outpatient hospital records using ICD-10, CPT, HCPCS, and other third-party payor codes
• At least two (2) years of lead or supervisory experience
• Certified Professional Medical Auditor (CPMA) certification preferred
• Strong organizational and communication skills, comfortable interacting with physicians and various stakeholders

Work Schedule & Location:

• Schedule: 9/80 work schedule
• Location: 7898 Mission Grove Parkway, Riverside

Why RUHS Medical Center?
Riverside University Health System-Medical Center is nationally recognized for its innovative, progressive care and is considered one of the top employers in the region. The 439-bed Medical Center is a designated Stroke Center, Level I Trauma Center, and home to the only Pediatric ICU in the area.

Can you see yourself here? For more information about RUHS Medical Center, please visit www.ruhealth.org .Establishes implements and maintains a review process for coding/CDI compliance, including a formal review (audit) process.

Reviews inpatient and/or outpatient coded records for quality and comprehensive coding and documentation to ensure compliance with ICD-10-CM, CPT4, and HCPCS level II coding conventions.

Analyzes and interprets coding data to identify problems or trends.

Ensures compliance with clinical documentation Integrity, coding standards and government regulations.

Maintains knowledge of coding and billing requirements and regulatory changes.

Assists in the ongoing development and maintenance of a coding/abstracting policies, procedure and practice standards.

Audits, reports and documents all results to the Compliance officer utilizing spreadsheet/software algorithms as necessary.

Provides, initiates, and supports training/education for the coding and compliance regulations to all RUHS staff as needed. Creates videos and educational modules on updates as required.
Supports the education and compliance for RUHS post query, re-coding and re-billing process.
Assists with organizational training and skills assessment for ICD-10-CM/PCS.

Actively communicates and provides timely feedback to all coding and nursing affiliates as necessary.

Ability work independently with minimum supervisionEducation: Graduation from an accredited college or university with a bachelor's degree, preferably with a major in accounting, business or public administration, information services, finance, or a closely related field to the assignment. (Additional qualifying experience may be substituted for the required education on the basis of one year of full-time experience equaling 30 semester or 45 quarter units of the required education.)

Experience: Three years of experience in an administrative or staff capacity which must have included at least two years of experience supervising professional and technical staff in two of the following areas: gathering and compiling facts and statistics to evaluate program effectiveness and recommend program revisions; preparing and maintaining a program budget or maintaining and controlling the fiscal record keeping functions and systems in a department, agency, division, unit or company; coordinating and conducting studies of administrative and operational activities including budget preparation and control, equipment usage, staff patterns, work flow and space utilization. (Possession of a Master's degree from an accredited college or university in accounting, business or public administration, finance, or a closely related field may substitute for up to two years of the required experience on the basis of 30 semester or 45 quarter units equaling one year of full-time experience.)

Preferred Experience: The ideal candidate for this position will possess five (5) years of experience coding inpatient and/or outpatient records in a hospital utilizing ICD-10/CPT/HCPCS and other third-party payor codes. This experience must include at least two (2) years of lead or supervisory experience.

Certifications (required): Must possess and maintain at least one of the following:

• Certified Coding Specialist (CCS)
• Certified Professional Coder (CPC)
• Registered Health Information Tech/Administrator (RHIT/RHIA)
• Certified Document Integrity Practitioner (CDIP)
• Certified Professional Medical Auditor (CPMA)

What's Next?This recruitment is open to all applicants. Applicants who are current County of Riverside employees and/or current employees of Riverside University Health System may be considered before other applicants, depending on the volume of applications received.
Application Period
BASED ON THE NUMBER OF APPLICATIONS RECEIVED, THIS POSTING MAY CLOSE WITHOUT NOTICE.
Applications received prior to the closing date will be considered based on the information submitted. Changes or alterations cannot be accepted. All applicants must submit a complete application by the closing date of this recruitment. No late applications will be permitted.
Include relevant work experience details on resume and/or application.
Applicants who fail to provide information demonstrating they possess the position requirements may not be considered further in the application process. A description of job duties directly copied from the job classification or job posting will not be considered.

Upload a copy of any license(s), official/unofficial transcript(s), degrees, and/or related employment documents to your NeoGov account. If your education was completed outside of the United States, you will need to provide a copy of your Foreign Education Equivalency evaluation from a member of the National Association of Credential Evaluation Services ( NACES ) or Association of International Credential Evaluators, Inc. ( AICE ).

For questions about this recruitment, please contact:Angela Levinson
Email: alevinson@rivco.org
Phone: 951-955-5562