Job Description

Job Description

Job Description

RESPONSIBILITIES:

• Act as a resource

• Demonstrates the ability to request, review, and code medical services from reports and notes in order to convert procedural and diagnostic notes into appropriate levels of care following coding rules and regulations.

• Thorough understanding of Medicare, Medical, and other payor guidelines.

• Identifies documentation deficiencies and recommends methods for resolution that satisfy regulatory and compliance requirements.

• Performs medical chart audits, meeting minimum department productivity standards.

• Exercises mature judgment and maintains confidentiality in all activities.

Coding and compliance:

• Identify areas of potential coding, billing, and documentation deficiencies.

• Provide suggestions to resolve areas of deficiencies to management.

• Identify areas of potential Compliance risk and notify management immediately.

• Ensures the accuracy of all work and strives to achieve 100% accuracy.

• Identifies anomalies in coding and fixes them immediately.

• Identifies ways to avoid errors and issues and creates safeguards to prevent them from happening again.

Data collection and reporting:

• Demonstration of strong knowledge of coding software, databases used by the Company

• Continually strives to increase knowledge of electronic data systems and reporting tools to enhance value.

• Designing and developing special reports within a specified timeframe.

• Participation in job-related conferences, seminars, and workshops.

• Review of various coding publications for changes and relay information to pertinent parties.

• Maintains average Billing lag days of 7 days of less.

Data entry:

• Verifies that each charge contains the necessary charge elements on EMR and Salesforce

• Special Projects - participates in projects that improve department production and/or efficiency.

• Identifies and trends errors.

• Ensure all charges are entered correctly and accounted for.

• Be able to perform charge entry and all other charge-related procedures.

General support:

• Perform other duties as assigned.
• Process improvement
• Independently researches coding questions, documents findings, makes recommendations and provides documentation that supports the recommended solutions.
• Provides professional and courteous support to Revenue cycle and commercial teams through email, phone and in-person contact, answering questions and providing supporting documentation.
• Provides timely and accurate answers to inquiries presented by customers on clinical coding issues.
• Maintain a positive attitude and productive relationship with peers, physicians, coworkers and management.
• Provides updates and status reports to management.
• Participates in coding/auditing discussions to ensure that the best practice efforts and processes are followed to allow for maximum reimbursement through appropriate coding.

Required Qualifications:

• Minimum 13 years in Revenue Cycle Management
• Experienced in change entry and coding
• Coding certification

Preferred Qualifications:

• MBA, CPA, or CMA
• Knowledge of Accounting & Finance

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