Coding Compliance Coordinator
This is not an entry-level coding position, must have at least two years of coding and the ability to accurately audit, train and provide feedback to physicians.
The CCC provides professional services: auditing, training, consultation, audit and feedback to clinicians on their documentation and coding to ensure TVC receives appropriate reimbursement and conforms to applicable guidelines and regulations. Advocates compliance with all third party billing and reimbursement requirements including, but not limited to, the requirements of Medicare and Medicaid programs. Serves as the coding subject matter expert for the physicians.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
- Performs audits utilizing an in-depth knowledge of ICD-10, CPT and HCPCS coding, Correct Coding Initiatives (CCI) and documentation guidelines.
- Provides training for all New and Established Providers to ensure correct documentation and coding of procedures and diagnoses.
- Through the attendance of provider department meetings, provides coding and documentation education and training.
- Performs coding reviews for providers based on areas of deficiency and also to support CMS required annual audits.
- Provides ad-hoc audits of Providers when requested by Department Managers and Department Chairs to address areas of concern.
- Supports the development of documentation and coding policies and procedures.
- Utilizes understanding of Practice Management system to recommend Master File changes to facilitate correct claims coding per carrier specifications.
- Ongoing dissemination of information to Providers, Clinical Coders, and Clinic Managers to inform about coding policies via email, memos and periodic meetings.
- Monitoring of Clinical Coders’ coding knowledge via audits and other mechanisms, keeping Operational Support Supervisor informed and soliciting intervention if deficiencies are identified.
- Provides coding workshops and training sessions for CBO charge entry staff as requested.
- Participates in projects to enhance coding and charge entry functions clinic-wide
- Works with Central Business Office (CBO) to enhance the effectiveness of software including the Practice Management system.
- Performs other related tasks as assigned.
EDUCATION AND SKILLS
- High school diploma or equivalent required.
- Current CCS or CPC certification or equivalent required.
- At least two years of CPT, ICD-9 coding systems and chart auditing experience preferred.
- ICD-10 certification preferred.
- Certified Professional Medical Auditor (CPMA) preferred, or ability to obtain within one year of employment.
- Experience working in a medical office setting required, with demonstrated understanding of standard insurance reimbursement methodologies preferred.
- Experience educating physicians regarding coding, charting and other relevant processes, in an individual and group setting preferred.
- Knowledge of medical terminology and anatomy and ancillary tests/procedures.
- Excellent organizational skills and strong attention to detail required.
- Strong oral presentation skills.
- Must have demonstrated competence with computer systems including electronic health records, Microsoft Office Suite required.
- Valid Driver’s license, insurance, and access to an automobile required.
- Typing skill of at least 40 wpm.
- Working knowledge of ICD-9, ICD-10, CPT, and HCPCS coding and Correct Coding Initiatives (CCI)
- Ability to train and audit new and established providers as skills are mastered.
The above information is intended to indicate the general nature and level of work required in this position. It is not designed to contain or be interpreted as a comprehensive description of all duties, responsibilities, and qualifications required of those assigned to this job.
We offer a competitive Total Rewards Program which includes insurance programs covering medical, dental, vision, life, long-term disability, generous time off, holidays, education reimbursement, and a 401(k) plan. Eligibility for benefits is dependent on factors such as position type and FTE. Contact your recruiter for more information.
Vancouver Clinic is proud to be an Equal Opportunity Employer. Vancouver Clinic does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, gender identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.