Coding Compliance Analyst

Legacy Health

1d•$31 - $44•Remote

About The Position

You recognize that your coding and compliance expertise serves a greater purpose within the Legacy community - improving the lives of others. By developing, implementing, and monitoring systems that ensure compliance with Medicare and other payor documentation guidelines, you uphold the standards of excellence that define Legacy.

Requirements

Associate’s degree in business or healthcare, or equivalent experience, required.
Minimum of two years healthcare experience required.
Strong communication skills, both verbal and written.
Ability to speak in front of large and small groups.
Proven ability to develop training programs, provide training and oversee work processes.
Excellent organizational skills and the ability to handle large volumes of work. Demonstrated understanding of insurance reimbursement and payment methodology. Competent in Microsoft Excel and Word software.
RHIT, RHIA, CCS, CCS-P or CPC certification required.

Nice To Haves

CPT/ICD9 experience in a multi-specialty setting preferred.
Database experience preferred.

Responsibilities

Works closely with Regulatory department to support adherence to compliance policies relating to professional coding.
Provides new physician orientation related to regulatory compliance, documentation and coding guidelines.
Analyzes physician practices to identify charge opportunities and ensure all billable services are captured.
Provides in-services to providers and staff on proper coding and documentation.
Oversees the set-up of new CPT Codes.
Updates and reviews fee tickets annually and ensures system files are updated accordingly.
Identifies need for and enlists consultant services as needed.
Participates in reimbursement analysis to determine if denials relate to CPT or diagnostic coding.
Defines criteria for payor specific reimbursement for correct payment analysis.
Investigates payor response to new CPT/HCPCS codes.
Analyzes and documents the patient account cycle for each physician or physician line of business for timely and accurate processing.
Provides onsite initial and ongoing CPT and ICD-9 training to providers and staff.
Acts as a resource to physicians for CPT and diagnostic coding questions.
Performs regular audits to ensure compliance with coding and documentation guidelines. Provides feedback to physicians, both written and verbally, regarding coding and documentation accuracy.