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Keck Medicine of USC

Keck Medicine of USC is one of only two university-based medical systems in the Los Angeles area. Its internationally renowned physicians and scientists provide world-class patient care at Keck Hospital of USC, USC Norris Cancer Hospital, USC Verdugo Hills Hospital and more than 80 outpatient clinics in Los Angeles, Orange, Kern, Tulare and Ventura counties.

Keck Medical Center was ranked No. 16 on U.S. News & World Report’s 2019-20 Best Hospital Honor Roll and among the top 3 hospitals in Los Angeles and top 5 in California. The hospital also ranked in the top 4 in urology (tie); top 10 in geriatrics; top 15 in ophthalmology, cardiology & heart surgery, gastroenterology & GI surgery and nephrology; top 20 in neurology & neurosurgery; top 25 in cancer; and top 35 in pulmonology & lung surgery.

Specialist, Regulatory Compliance and Revenue Integrity - Healthcare Compliance - Full Time 8 Hour Days (Exempt)

Administration Hospital Los Angeles, California

Has responsibility for investigating and responding to matters regarding complex coding, documentation, compliance and/or reimbursement; developing, planning and conducting comprehensive coding and/or documentation training for physicians and other staff; assisting with development and implementation of new related policies and procedures; functioning as quality assurance coordinator; conducting quality control studies of coded data and documentation to ensure compliance; participating in claims review process; overseeing design and revision of divisional billing forms; overseeing billing dictionary updates related to ICD-9 and CPT4 codes; and conducting inpatient and outpatient chart reviews.Works closely with USC Health System administrators and/or providers, as appropriate.


Minimum Education: • High School Degree or equivalent required. • Associate’s Degree in Health Information Technology or related healthcare degree; • OR Associate degree in Nursing or an accredited Registered Nurse Program as evidence by licensure or certification in any of the following: RHT, RHIA, CCS, CPC-H required. Minimum Experience/Knowledge: Required: • 3 years’ experience in a related field. • Experience working in a health setting reading and understanding clinical and hospital health records. • Candidates should satisfy at least one set of the following: • Certification in any one of the following: RHIT, RHIA, CCS, CPC-H. Intermediate Comprehensive knowledge of ICD-9-CM, CPT and HCPCS coding. Intermediate Comprehensive and coding both facility and professional services, utilizing ICD-9-CM,CPT and HCPCS. • Clinical experience as a RN or LVN in a case management or case coordinator role • with experience on patient status determinations, Interqual and documentation. • Clinical background as a RN or LVN with experience in medical auditing in an acute • care setting. • Clinical experience as a RN or LVN with expertise of case delivery documentation and related medical record documentation in an acute setting. • Knowledge of medical terminology or equivalent recent training or education. • Knowledge of auditing concepts and principles. • Basic knowledge of biology/anatomy/disease processes, laboratory test and uses, prescription medications and their respective guidelines. Preferred: • 3 years coding quality, documentation and hospital compliance experience. • Knowledge of MS-DRG grouping, APC’s and HCC’s. • Teaching/Training. • Working knowledge of inpatient admission criteria. • Working knowledge of Medicare reimbursement system and coding structures. Required License/Certification: Candidates should satisfy at least one set of the following: • RHIT, RHIA, CCS, CPC-H • RN • LVN • Fire and Safety Certification: If no card upon hire, one must be obtained within 30 days of hire, and maintained by renewal before expiration date. (Required within LA City only).


REQ20089842 Posted Date: 06/12/2020

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