• Data Validation Specialist

    Job Locations US-AZ-Tucson
    Job ID
    2018-1677
    Category
    Administrative/Clerical
    Type
    Regular Full-Time
    Field
    Mental and Behavior Health
  • Overview

    Under general supervision, reviews and audits medical records to ensure that documentation justifies the data billed on encounters. Using established methodology, determines omissions and measures timeliness of encounter submissions. Provides verbal and written technical assistance and ongoing education to staff, in order to resolve identified errors.

    Responsibilities

    • Conducts reviews/audits of the medical records of ICHD members enrolled in the Arizona behavioral health system.
    • Compares medical records and encounter data submissions utilizing the Covered Service Guide; and/or ICD10, DPT and HCPC’s manuals, guidelines and rules.
    • Monitors correction of errors, and tracks resubmissions in order to justify accurate coding of services provided.
    • Provides verbal and written technical assistance to staff in order to resolve identified errors.
    • Provides initial and ongoing education and training to staff at all levels of the organization, including practitioners with Intermountain Health Center.
    • Identifies, coordinates and implements process improvement initiatives.
    • Assists in coordinating the data validation activities of ICHD and contracting behavioral health networks or Regional Behavioral Health Authorities (RBHA’s).
    • Assists Independently Licensed staff apply for credentialing, including completion of NPI and AHCCCs number requests.

    Qualifications

    Education/Experience

    • Bachelor’s Degree, or training and experience equivalent to a Bachelor’s degree preferred; HS/GED required.
    • Three years’ experience auditing and/or monitoring electronic healthcare records required.
    • Two years’ experience in claims processing required.
    • At least one year of experience with facility supervision preferred.

    Certifications

    • Certification as a Medical Coder required and/or ability to achieve certification within 3 months of hire

    Legal Requirements

    • Current valid Arizona Driver’s license
    • 39 month Motor Vehicle Report, vehicle registration and liability insurance to meet insurance requirements.
    • Eligible for DPS Level I fingerprint clearance
    • A current negative TB test result (ICHD provides)

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