JOB SUMMARY Support and provide coding and compliance training to clinical personnel, billing, and/or other client staff. Establish effective communication with clinical staff, and/or hospital staff to address documentation, coding, and reimbursement issues. Use knowledge of coding and compliance guidelines to identify potential billing / reimbursement issues. Participate in special audits and system administration as necessary. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Performs diagnosis data submissions to Client, Vendors and internal Stakeholders Develop monthly productivity and revenue projections Responsible for chart assignment oversight and monitoring accounts on hold Prepares data collection reports for leadership Monitors diagnosis submission progress; Audit diagnosis submission files to ensure accuracy Reviews, analyzes and oversight of prebill/post bill reviews and pending accounts Works to resolve workflow, systems and complex matters related to coding KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Proficient in inpatient and/or outpatient diagnosis and procedure coding guidelines Proficient in CPT/HCPCS code assignment including Evaluation & Management facility coding guidelines Knowledge of MS-DRG, APR DRG and CPT classification and reimbursement structures Proficient at writing AHIMA complaint physician queries Adept at comparing documentation, code assignment and charge in the financial system for accuracy and completeness Functional knowledge of facility EMR, encoder, CDI tool and other support software Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities, and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost, and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step!
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Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees