Facility: Administrative Regional Training Cntr
Shift: Shift 1
Status: Full Time FTE: 1.066667
Bargaining Unit: Catholic Health Emmaus
Exempt from Overtime: Exempt: Yes
Work Schedule: Days
Hours:
Monday to Friday: 8 - 5
Summary:
Responsible for the overall efficient operation of CHS Outpatient Coding and Private Client Medical Coding and Chart Audit Services.
Responsibilities:
SKILL AND EDUCATIONAL REQUIREMENTS (MINIMUM):
The successful candidate will have: A thorough understanding of Current Procedural Terminology (CPT) codes, International Classification of Diseases (ICD-10) diagnosis codes and appropriate modifier use. Experience with AHA Coding Clinic and CPT Assistant as resources
- Requires extensive knowledge of Medicare and Commercial Payers coding and billing policies. They will ensure documentation compliance with governmental and third-party Payer regulations
- Knowledge of National Correct Coding Initiatives (NCCI) edits, National and Local Coverage Determination Policies (NDC and LDC) and Medically Unlikely Edits (MUE)
- Strong research capabilities with respect to Medical procedures and technology; and an excellent knowledge of Medical terminology
- Excellent computer skills- Word, Excel, multiple EHR systems and electronic encoders
- Excellent communication skills- Daily communication with Clients as well as supervising a talented and diverse team of Medical Coders
- Works well in a team environment and has the capability to multi-task several responsibilities
- Recognizes and protects the confidentiality of all patient and employee information according to HIPAA policy.
- Interfaces well with external and internal Professionals at all levels- Medical, Legal, and Clerical
EDUCATION
- Minimum of Bachelor’s degree in a related health or science field with 5 –10 years of Medical Coding experience
- Medical Coding certification through American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is also required with multiple certifications a plus
EXPERIENCE
- 5- 10 years of multi-specialty coding with supervisory experience
KNOWLEDGE, SKILL AND ABILITY
- Resolves insurance denials through the research of Payer policies, NCCI edits, and coding guidelines
- Updates and maintains Payer policies specific to each Client along with databases of coding guidelines
- Educates Clients and staff on correct Coding guidelines and provides annual CPT, ICD-10, and vaccine updates
- Supervises and mentors the Medical Coding Team to ensure they provide Clients with the highest level of Medical Coding service
- Responsible for overseeing all audit activities- internal, external, and third-party prospective and retrospective payer audits including Federal and State agencies. Ensures compliance of CPT and Medicare regulations with respect to Coding and documentation guidelines
WORKING CONDITIONS:
- Normal heat, light space, and safe working environment; typical of most office jobs
- Long periods of sitting
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