CODING / AUDIT SPECIALIST - Mabry Eye

GALEN MEDICAL GROUP PC•Chattanooga, TN

1d•Onsite

About The Position

Under direct supervision of the Supervisor – Internal Audit, the incumbent is responsible for conducting review of charges to ensure appropriate assignment of alpha / numeric procedure and diagnosis codes and modifiers as appropriate. Conducts analysis of all denied claims and review of medical record to identify coding errors, make appropriate corrections. Conduct claim re-submission or appeal as appropriate.

Requirements

High School Diploma or GED equivalent is required.
Certified Professional Coder (CPC) or Certified Coding Specialist – Physician Based (CCS-P) required.
One to three years physician coding and auditing experience preferred.
Knowledge of pathophysiology and disease processes
Knowledge of medical insurance and payer guidelines.
Knowledge of the regulatory/reporting requirements that pertain to the assigned function.
Effective organizational and problem-solving skills are required
Demonstrated ability with medical billing / electronic medical record systems
Knowledge of third-party billing / payment guidelines.
Good verbal and written business communication skills

Nice To Haves

Associates Degree in Health Information Management is desirable.

Responsibilities

Audits medical record documentation for accurate assignment of diagnosis, current procedural terminology, and evaluation / management codes.
Researches coding and reimbursement issues and reports findings to management, physicians and staff.
Performs internal quality assessment reviews on physician (professional) coding to ensure compliance with national coding guidelines and Galen Medical Group policies for complete, accurate, and consistent coding which results in appropriate reimbursement and data integrity.
Assists Supervisor with preparation and interpenetration of monitoring results for review with physicians, midlevel providers, and management.
Performs compliance audits, risk assessments and investigations as it relates to billing, coding, and reimbursement compliance.
Promote the mission, vision, and values of Galen Medical Group.
Maintain confidentiality of all patient, medical, financial, and legal information.
Report to work on time and as scheduled.
Wear identification during work hours.
Represent the organization in a positive & professional manner.
Ability to handle difficult situations involving patients, physicians, or others in a professional manner.
Ability to work independently, exercise creativity, be attentive to detail, and maintain a positive attitude.
Comply with all organization policies and standards regarding ethical business practices.
Participate in performance improvement and continuous quality improvement activities.
Attend regular staff meetings and in-services as directed by your manager.
Consistently demonstrate the value of team concept.
Ability to manage multiple and simultaneous responsibilities.
Complete assignments efficiently and in a timely manner.
Understands and abides by OSHA, HIPAA & CLIA standards.
Perform all duties in compliance with Galen Medical policies, HIPAA, and OSHA standards.