Wichita Clinic
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Job Location: Wichita, Kansas
Department:
Business Office
Facility:
Medical Arts Tower
Hours:
M-F 8-5
Category:
Administrative
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POSITION PURPOSE
Functions as a coding compliance resource and consultant for all physicians, non-physician providers (NPP’s), administration, management, clinical and business office staff.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
Assures coding compliance through concurrent audits of documentation and coding work files.
Identifies through focused specialty audits, operational and regulatory issues related to coding, analyzes ICD-9-CM and CPT codes assigned by coding personnel and verifies that the coding is in accordance with coding compliance standards.
Ensures that charges have been coded in compliance with the Centers of Medicare and Medicaid Services (CMS), third party payer and OIG regulations.
Performs ongoing quality assessments of clinic coding through statistical sampling techniques.
Develops reports of error thresholds, error rates and their causes.
Identifies and documents positive and negative coding trends through daily interactions with physicians, NPP’s and other coding/billing staff.
Plans and carries through to completion proactive studies to assess coding quality.
Formulates and implements recommendations for education and process improvement, providing in-service presentations as needed.
Develops ad hoc reports with recommendations to assist with risk assessment and Compliance program monitoring.
Prepares statistical reports and recommendations to administration/management for comparative analysis of provider billing compliance, using CMS billing performance data and other sources.
Implements corrective action plans and provides ongoing monitoring as needed.
Develops and implements curriculum used in orienting and educating physicians and staff on documentation guidelines, diagnostic and procedural coding, and billing conventions and methodologies.
Identifies, develops, and provides education and training for providers and staff based on investigations/audit results.
Provides coding support and input for resolving complex coding work queue edits, and researches multi- specialty coding questions.
Analyzes and prepares reports on provider practice patterns as well as new product /services feasibility studies.
Assists with developing claims scrubber system edits based on coding denials and trends to proactively maximize revenue.
Assists with annual review and updating of diagnosis and procedure coding, encounter forms and templates.
Develops and maintains job procedures and forms for audits and analysis, sample methodology, data collection, and review reports.
Serves on various committees as requested.
Stays informed of current developments in coding and billing guidelines.
Coordinates special studies and projects.
Performs other departmental duties which may be inclusive, but not listed in the job description.
QUALIFICATIONS
EDUCATION/CERTIFICATION: Requires CPC, RHIT, RHIA, or CCS-P certification. Prefer completion of a two to four year program in Health Information Technology or Administration, or Certified Coding Program. Prefer college level courses in medical terminology, biology, anatomy and physiology, basic pathology, ICD-9-CM, CPT, HCPCS.
EXPERIENCE REQUIRED: Prefer 3-5 years of coding and medical billing experience in a multi-specialty physician billing environment in addition to knowledge of payer billing guidelines and documentation guidelines. Thorough knowledge of coding and coding compliance guidelines as well as previous auditing experience preferred
COMPUTER EXPERIENCE: Experience using Microsoft Office Suite products including PowerPoint. Requires excellent skills and/or understanding of data analysis and presentations such as Excel pivot tables, Visio presentation, graphical statistical displays, flow charts, organization charts, time lines etc. Proficient at Internet research. Ability to work effectively with computerized databases.
Compensation/Benefits:
We offer our employees a competitive wage/benefits package as well as a family friendly work schedule-no evenings, no weekends and no holidays!
How To Apply:
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Wichita Clinic
Wichita Clinic is an Equal Opportunity Employer
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