Coding & Compliance Specialist

UR Thompson Health•Town of Canandaigua, NY

5d•$20 - $25•Onsite

About The Position

Thompson Health is seeking a Coding & Compliance Specialist to join their team. This role is responsible for ensuring compliance with coding, billing, documentation, and payer regulations within the health system. The specialist will conduct medical record audits, analyze coding practices, and provide guidance to providers and billing staff. This position requires strong knowledge of hospital third-party insurance billing, federal and state regulations, and electronic medical records.

Requirements

Demonstrates skills in customer service, communication, team building and problem solving.
Demonstrates competency in all areas of hospital third party insurance billing including federal and state regulations.
CPC-A required
Excellent communication skills and ability to form collaborative partnerships across all service settings.
Proficient in the use of Electronic Medical Records (EMR); ability to create reports on own and interface with EMR vendor to develop reports where none currently exist
Extensive knowledge RBRVS and federal, state, and other payer regulations pertaining to documentation, coding (E&M, modifiers, critical care) and billing.
Ability to analyze coding and actively question and guide providers and/or Billing staff as appropriate.
Strong medical terminology background
Competent in Microsoft Office products (Word, Excel, Outlook, PowerPoint).
Self-directed, self-starter and able to implement new program
Accepts responsibility and follows through on projects and activities.
Ability to assimilate new information and technologies into daily work.
Skills in using computers including Excel and Word required.

Nice To Haves

Electronic Medical Record experience preferred
Highly organized and detail oriented
CPC or CPC-H preferred
Associates degree, preferred
3-5 years of healthcare experience, preferred
Billing Experience preferred
Excellent public/patient relations and communication skills.

Responsibilities

Coordinates and conducts periodic medical record audits for providers to assess compliance with coding (over/under coding, trends), billing, documentation, and payer regulations.
Develops reports as directed.
Reports findings to management and providers.
Proactively resolving problems, recommending, and implementing process changes.
Communicating with patients, payer representatives and associates throughout the Health System.