Cape Cod Healthcare
Cape Cod Healthcare (CCHC) is an award-winning, comprehensive regional healthcare system based in Hyannis, Massachusetts with more than 500 physicians, two acute-care hospitals, home health services, skilled nursing and rehabilitation facilities, an assisted living facility and more than 4000 employees. CCHC was recently named one of the top 10 healthcare organizations in the country, according to Thomson-Reuters, a leading source of healthcare information. Quality, safety, and patient satisfaction are at the heart of everything we do! We are currently seeking a dedicated Specialist to join our Internal Audit team at Cape Cod Healthcare.
Cape Cod Healthcare offers competitive salaries, excellent benefits packages, tuition reimbursement, and generous paid time off.
PURPOSE OF POSITION:
Responsible for ongoing analysis of clinical and billing documentation and related issues to assess the appropriateness of coding levels, patient medical record documentation coverage determinations and reimbursement levels.
Bachelor's Degree in Nursing with strong knowledge of medical conditions and clinical process.
Certification in or strong working knowledge of Case Management, Utilization Management and other comparable clinical areas.
Minimum of 2-3 years of previous experience with clinical coding, reimbursement managing complex data and utilization issues.
Working knowledge of DRGs and APCs as well as third party reimbursement systems.
Must be able to prioritize and handle multiple work assignments
Excellent communication skills, both oral and written, with emphasis on report writing.
Computer skills - Strong Excel and Word knowledge.
Job ID: 494561