SCOPE/GENERAL PURPOSE OF JOB:
This position is responsible for providing consulting services to physician practices, billing companies, hospitals and other related healthcare entities with a concentration on coding/compliance audits of physician and hospital outpatient claims coupled with coding education.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Perform coding/compliance audits of physician and hospital outpatient services, either at the client’s location or remotely, per client preference and consistent with the scope of the contract.
- Create and deliver accurate and well-written audit reports, including clear explanations of errors as well as authoritative guidance for coding recommendations for all projects
- Prepare customize training materials to the client’s specific needs.
- Maintains confidentially of all information related to patients, medical staff, finances and all other RCCS and client information.
- Demonstrates thorough understanding and ability to research all aspects of coding, compliance, documentation and reimbursement for assigned specialties.
- Maintain accurate records of time spent on tasks for both client and non-client projects.
- Submit accurate invoices and expense reports timely to the appropriate internal departments following corporate guidelines.
- Adheres to all RCCS Corporate Policies and Procedures.
- Assist with other duties as assigned.
EDUCATION AND/OR EXPERIENCE:
- Minimum three (3) years of job experience as a consultant, educator, or compliance professional in healthcare
- AHIMA or AAPC coding credential is preferred. Must be willing to obtain coding certification within one year
- Knowledge of coding, documentation and reimbursement.
- Knowledge of organization policies and procedures.
- Knowledge of health care administration principals.
- Knowledge of business office procedures.
- Skill in exercising initiative, judgment, discretion and decision-making to achieve objectives.
- Skill in identifying and resolving problems.
- Ability to establish and maintain effective working relationships with all employees and clients.
- Knowledge of CPT, ICD-10-CM and HCPCS coding related to Evaluation and Management, radiology, surgical and/or oncology practices.
- Highly detail-oriented individual with outstanding analytical and writing skills, and ability to communicate professionally with clients and employees of RCCS.
- Must be competent and comfortable with MS Word, Excel, and PowerPoint.
SUPERVISORY RESPONSIBILITIES: None
The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position requires full range of body motion including manual and finger dexterity and eye-hand coordination. The position additionally requires standing/sitting for extensive periods of time. Occasional lifting and carrying items weighing up to forty (40) pounds may be required. Requires corrected vision and hearing to normal range.
The work environment characteristics described are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment involving frequent interaction with staff, clients and the general public.