Responsible for performing internal CPT/ICD-9 and provider documentation coding and billing compliance reviews, specific to surgical departments, of various elements of physician billing for the Fallon Clinic and affiliate practices.
Works within specified third party payer and federal (CMS) coding/billing regulations.
Develops training and education materials.
Provides training and education to providers, Clinical Departments and Patient Accounts Department staff.
Provides other internal billing-related compliance services to the organization as required.
Measures coding trends as compared to national standards.
Major Responsibilities: Customer Servic
1. Fosters excellent quality customer service standards in daily operations.
2. Communicates and interfaces with providers, staff, patients, family members and others to ensure high-quality patient care.
3. Corrects unsatisfactory conditions that may arise or notifies manager or others of any discrepancies4 Greets patients and visitors.
Ascertains their needs, and provides standard information as required.
5. Performs cross-functional duties as necessary/assigned6 Maintains and develops harmonious relationships with co-workers, providing support and assistance to ensure quality customer service/patient care7 Intervenes in complicated customer service situations8.
Serves as a role model for other staff members.
Displays behaviors and attitudes consistent with ensuring the ideal patient experience.
General1.
Participates in the identification and resolution of areas requiring additional intervention through established work plan.
2. Develop and implement clinic-wide training programs geared towards educating clinical and non-clinical support staff regarding compliance related topics3.
Develop and deliver clinic-wide newsletter pertaining to relevant revenue integrity initiatives4 Assist in the review and update of annual Revenue Integrity & Education work plan5 Ability to train providers and staff in a small to large group session6 Capable of meeting deadlines, productivity targets7 Ability to communicate effectively at all levels in the organization, including clinical and non-clinical support staff, practice managers, physicians, and medical leadership8 Responsible for conducting random and scheduled internal audits of physician billing and medical record documentation to ensure: Correct Coding (CPT, ICD-9, HCPCS, Modifiers), Accurate Data Entry, Accurate Charge Preparation/Processing, Compliance with governmental and third party billing regulations9.
Utilizes Microsoft Excel / Word, to document and report audit results to the appropriate personnel, including physicians/providers.10. Works with clinical department physicians, mid-level providers and other staff to ensure appropriate and compliant documentation, coding and billing practices11.
Develops and tracks progress of internal audit schedules12.
Serves as an internal compliance resource for Patient Accounts, Clinical departments, and for coding and documentation questions.13. Utilizing the Internet, intranet, internal reference library, available workshops and/or seminars and other sources, stays current with government and local third party payer coding, specialty-specific and reimbursement rules and requirements.14. Measures and reports coding trends as compared to national standards; or claim/documentation reviews.
Documents and reports results to all appropriate parties15.
Monitors and reports productivity and other data as requested by manager16.
Participates in all governmental and third party insurance audits17.
Assists in developing Revenue Integrity and Education Policies and Procedures Candidate must have 2 years previous Surgical coding and auditing background.
Specialties include: General, Vascular, Plastics, ENT, Ortho, Urology.
A minimum of 1 Year Surgical Specialty CPT/ICD-9 and HCPCS Coding experience required.
Please apply at: http://jobs.
fallonclinic.org/jobview.aspx?intid=272
CPT / ICD 9 Surgical Coder Job in Worcester 01608, Massachusetts US