The Brookdale Hospital & Medical Center

  • SPECIALIST, CODING AND COMPLIANCE (FACULTY PRACTICE)

    Job Locations US-NY-Brooklyn
    Posted Date 1 month ago(1/17/2019 11:38 AM)
    Job ID
    2019-5172
    # of Openings
    1
    Department
    B0610-1512-FACULTY PRACTICE PLAN
    Shift
    Day
    Type
    Full-Time
  • Overview

    Responsible for the compliance oversight of all revenue activity related to coding and documentation for physician services Analyzes denials, rejections and appeals reports from a compliance perspective to identify training opportunities and compliance issues. Works closely with the Compliance Office to facilitate physician reviews, training and assist with documentation of policies and procedures.

    Responsibilities

    • Utilize EPIC and related modules to obtain, analyze and interpret coding, denial and other reimbursement data to support practice management activities for professional billing.
    • Ensure all professional services that are documented in EPIC are coded with appropriate diagnoses and procedure codes.
    • Provide oversight for coding changes and when services are not documented appropriately, seek to attain timely clarification of conflicting, ambiguous, or non-specific documentation and act as resource or liaison to answer coding questions.
    • Educate staff and physicians based on annual code changes. Provide training and guidance to Faculty Practice physicians as it relates to coding changes and issues.
    • Maintain a working knowledge of CPT-4 and ICD-9/10-CM coding principles, governmental regulations, protocols and third-party requirements pertaining to billing and documentation; Research coding for proposed new services to assure accurate coding and billing.
    • Coordinate with the Corporate Compliance office on the scheduling and implementation of annual coding compliance work plans.
    • Conduct one-on-one or small group education to physicians regarding the results of their periodic reviews while maintaining an exceptionally high level of professionalism.
    • Ensure maximum efficiency and reimbursement for properly documented services by ensuring appropriate modifiers are utilized to support the charge.
    • Review, modify, and recommend changes to policies and procedures and systems to improve professional fee coding and data management.
    • Conduct physician reviews of documentation/coding and billing utilizing advanced, specialized knowledge of medical codes and coding procedures to assign and sequence appropriate diagnostic/procedure billing codes, in compliance with government and third party payer requirements.
    • Routinely interact with physicians and other patient care providers regarding billing and documentation.
    • Prepare monthly reports for clinical staff identifying coding and denial trends to ensure compliance and identify training opportunities.
    • Attend periodic coding / charge entry meetings and training sessions as requested.
    • Work on special assigned Coding Hold and Managerhold buckets in athena.
    • All other duties as assigned.

    Qualifications

    Education:

    • Bachelor’s degree required. 

    Experience:

    • Minimum of seven years of experience coding and compliance (preferred Surgery, Orthopedic, etc.).
    • Prior experience using AthenaHealth practice management or similar system is required.

    Licensure/Certifications:

    • Completion of an AHIMA/CPC-Approved Coding Certificate Program.

    Knowledge and Skills:

    • Knowledge of medical terminology and medical abbreviations, and an RHIA, RHIT, or CCS-P credential is required. OMIG/OIG and compliance regulations.
    • Must possess a thorough working knowledge of ICD-9/10-CM and CPT-4 coding systems as demonstrated by certification through AHIMA/AACP.
    • Ability to fully utilize BHMC’s electronic record systems, equipment and other healthcare and billing systems relevant to this position.

    Physical Requirements:

    • Position requires prolonged periods of sitting and use of a computer and screen viewing throughout the working day.

    Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

     

    The statements herein are intended to describe the general nature and level of work being performed by employees, and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified.  Furthermore, they do not establish a contract for employment and are subject to change at the discretion of The Brookdale Hospital Medical Center.

     

    BHMC is an equal opportunity employer, it is our policy to provide equal opportunity to all employees and applicants for employment without regard to race, color, religion, national origin, marital status, military status, age, gender, sexual orientation, disability or handicap or other characteristics protected by applicable federal, state, or local laws.

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