Responsible for providing ongoing coding, documentation, and compliance education to providers and office staff. This role monitors coding and documentation performance through random chart audits and regular follow-up meetings, communicates findings, and supports improvement through additional reviews, analysis, and benchmarking. The position also provides continual coding and payer updates and researches coding issues as they arise.
Key responsibilities include:
- Orienting new providers and staff, including locum tenens and new residents, with ongoing review and training for up to six months
- Conducting monthly education for providers and staff through formal small-group presentations
- Reviewing notes related to patient or payer complaints concerning evaluation and management coding and patient requests for denials
- Communicating findings timely to patients, payers, and physicians as needed
- Performing bi-annual chart audits and pre-review processes for all providers
- Providing feedback and education on review outcomes and work relative value unit impact
- Completing Office of Inspector General focused audits for corporate compliance as needed
- Monitoring and analyzing utilization benchmark reports against CMS norms
- Coding difficult cases at provider request
This is a technology-driven role requiring competency in Microsoft Windows and participation in additional learning opportunities as needed.
Requirements & Qualifications
Certifications and licensure
- CPC, CCS, CCSP, RHIT, or RHIA required/preferred as specified
- Certified Professional Coder (CPC) or Certified Coding Specialist - Physician-based (CCS-P) required
- RHIT or RHIA preferred
Education
- High school diploma or GED required
Experience
- 4 years of experience in the medical field required
- 2 years of physician coding and billing experience required
- 1 year of direct physician contact required
Skills and qualifications
- Strong interpersonal, written, and communication skills
- Ability to educate effectively
- Self-starter with strong organizational skills
- Ability to exercise initiative and judgment
- Knowledge of medical terminology and anatomy
- Knowledge of Word, Excel, and PowerPoint preferred
- Competency in Microsoft Windows
Physical and working conditions
- Ability to handle stressful situations, including public contact, trauma, grief, and death
- Ability to wear required personal protective equipment
- Ability to move freely about the facility
- Good vision and hearing, with or without assistive devices
- Ability to sit, stand, and walk for long periods
- May require stooping, kneeling, and crouching
- Possible exposure to bloodborne pathogens and other infectious material
- Ability to handle multiple tasks and work independently
- Regular and predictable attendance required
Location
Michigan, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
8 months ago