Job Details: Regulatory Auditor

Description: Park Nicollet Health Services is seeking a Regulatory Auditor to work in our Contracting and Compliance Department.
Park Nicollet Health Services, an integrated healthcare organization, is one of the most trusted and recommended sources of personalized healthcare in the Twin Cities of Minneapolis/St. Paul. Our progressive and dynamic system includes Park Nicollet Methodist Hospital, Park Nicollet Clinic, Park Nicollet Foundation and Park Nicollet Institute. Park Nicollet is based in St. Louis Park and has more than 8,000 employees, including 690 physicians.

This position performs the facility coding and documentation audits for accuracy and completeness of coded medical records, investigates issues, recommends corrective action(s) and monitor corrective action to ensure compliance with federal coding, documentation, and billing regulations and guidelines. The Regulatory Auditor also researches, analyzes, and responds to inquiries regarding compliance, coding, third party payors, Medicare/Medicaid, denials, and billable services.

• Certification as a RHIA (Registered Health Information Administrator) or RHIT (Registered Health Information Technician) preferred.
• CCS (Certified Coding Specialist) or CPC (Certified Procedural Coder) preferred.
• Minimum Five years hospital auditing and or hospital coding experience.
• Knowledge of ICD-9-CM, DRG & APC coding guidelines, medical record charting, insurance billing and reimbursement.
• Knowledge of federal, state, and payer specific regulations and policies pertaining to documentation, coding, HIM operations, and billing.
• Outstanding written and communication skills.
• Able to work both as a team player and independently.
• Strong analytical abilities.
• Demonstrated aptitude for quantitative analysis and attention to detail.
• Able to identify problems and find creative, effective solutions.
• Able to balance multiple priorities.
• Proficiency with personal computers and related software.
• Expertise in reviewing documentation and determining ICD-9 diagnosis & DRG, CPT/HCPCS coding, and carrier coding and billing guidelines/regulations required.
• Detail oriented organized individual with the ability to discern the nature of the procedure and method used to determine appropriate CPT and ICD-9 code assignment.
• Willingness to maintain expertise to keep current with changes in procedure and diagnoses coding and third-party payor reimbursement policies through continuing education.
• Ability to work independently and on team projects; problem solving and decision making capabilities.
• Strong knowledge of anatomy and medical terminology.
• This staff member must constantly exhibit sensitivity and integrity and accept ongoing change as a challenge.
• Demonstrates excellent relationship skills.
• Possesses ability to work collaboratively and establish rapport with manager and staff of multiple disciplines to assure positive outcomes.
• Ability to establish personal and professional credibility in the organization.
To view this job opportunity and apply for it please visit our Career Center at www.parknicollet.com/careers , referencing job number 22879.

We do not accept paper applications or resumes. EOE/AA/Veteran Friendly Employer. No agencies.

Posting Date: Jul 23 08