I've done QI but this is different....

[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!!:sofahider

[renerian, BSN, RN]

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