[Kikumaru]

Dear All:
I am an avid reader of mostly the general posts! Today I need your help. I am interviewing for a position that goes beyond most of what I have done in the field of UM/QI/CM. Here is the job description:

"Quality Assurance Coordinator
This is a newly created position. The primary focus for this position will be to conduct internal audits for all company departments such as: Coding, Accounts Receivable, Support, Provider Enrollment, Customer Service, Private Pay Collections, Medicare/Medi-Cal Follow-up, etc. This position will report to the company Compliance Officer. They will work closely with our clients, management team, and staff.

Job Requirements
Candidate must be a Registered Nurse with a minimum of 2 years of previous auditing experience in a healthcare environment. Candidate must be extremely knowledgeable in physician billing and medical accounts receivable. Candidate should have a big picture perspective of the industry, with healthcare experience in Coding, Data Entry, Billing, Accounts Receivable, and familiarity with all insurances. A college degree in a related field is a big plus. Candidate must possess very good computer skills and have the ability to quickly learn new programs. Candidate must be very organized, detail-oriented, and be able to work independently on projects."

Most of this I know (i.e. coding, insurances, data entry, facility auditing and home health bill auditing). My questions are regarding accounts receivable, and provider enrollment.

I interview tomorrow at 1300 and would appreciate any help!!

[renerian]

For many health care entities this is what Outcome/OBQI etc has turned into. I usually spend a great deal of time on fiscal issues. I would say often I have been looking into things that require legal counsel so being comfortable asking about laws related to things like Stark Laws, State laws (endless list) is necessary, I have had to sign off fiscal reports, budgets; contract compliance and ensuring contracts are compliant to meet laws, rules, regs as well as accrediation standards/no enticements etcs; contractor relationships etc.

I maybe spent 50% or less of my time on patient related studies and the rest of non patient direct care or outcome information.

Coding compliance was a big thing. Coding is a huge legal risk if one is not doing it right. With ICD 10 lurking everyone will need retraining LOL.


I did not see this post or I would have replied in November. How did your interview go?

renerian