Coding & Compliance Specialist
About The Position
Required Job Specific Competencies: 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. Demonstrates skill in proactively resolving problems, recommending, and implementing process changes. Demonstrates skill in communicating with patients, payer representatives and associates throughout the Health System. 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. Electronic Medical Record experience preferred Highly organized and detail oriented
Requirements
- CPC-A required, CPC or CPC-H preferred
- 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.
- CPC-A required
- CPC or CPC-H preferred
- Skills in using computers including Excel and Word required.
Nice To Haves
- Electronic Medical Record experience 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.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
