SCOPE/GENERAL PURPOSE OF JOB:
Responsible for coordinating and providing consulting services to clients (i.e., physicians, physician groups, billing companies, hospitals, health systems, health care attorneys, and other health care entities) including coding/documentation audits, billing audits, compliance audits, general and targeted educational sessions, expert advice on coding, documentation, and billing topics, operational assessments and other engagements as assigned. Provide day to day oversight for the consulting team including the performance of ongoing QA of consulting team members, evaluate executed engagements and work with the Director to assign to appropriate consulting team member, and monitor progress to ensure projects are completed timely and accurately.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Manages the day to day functions of the consulting team. Including
- Ensure project management tools are appropriate utilized by the consulting team
- Review executed contracts with the Director for appropriate project assignments to the consulting team. Communicate and monitor project plans with the assigned consultants.
- Perform QA of final client deliverables prior to delivery to ensure accuracy and consistency with internal and external policies.
- Participate in orientation and onboarding of new team members
- Manage the client handoff between initial client contact and assigned consultant
- Manage projects and tasks assigned to the consulting team
- Perform QA of all new team members and provide educations as needed or coordinate the necessary education
- Partner with the Director to track data and information related to department goals
- Assist with the interviewing and hiring process.
- Prepare and participate in the annual evaluation process. Coordinate with the Director to complete the evaluation.
- Provides consulting services with client in accordance with their contractual agreement (onsite and remote).
- Defines expectations and timelines with clients and RCCS management in accordance with client contracts.
- Performs comprehensive documentation, coding, billing and/or compliance audits in accordance with client contract
- Create accurate well written reports summarizing audit findings and recommendations which include clear explanation of errors and references for authoritative guidance supporting recommendations when applicable.
- Present audit findings and recommendations in person or by phone
- Customize training material for client specific needs
- Deliver onsite or remote educational sessions
- Conducts and participates in webinar trainings, conference calls, creation of documents and materials for clients
- Other consulting projects as assigned (ex. CDM reviews, workflow assessments, denials management evaluations, etc.)
- Maintains an accurate record of time spent on all assignments (client and non-client work)
- Assist in creating and updating coding reference manuals and presentations as needed
- Monitors government regulations & programs and presents information to the company and clients
- Prepares and conducts information and education speeches for industry organizations
- Attends trade shows for marketing, vendor relations, clients and potential new business opportunities
- Prepares industry related articles for publication when requested
- Strives to achieve maximum exposure and strong public image of Revenue Cycle Coding Strategies to all industry stakeholders
- Works on ensuring a strong, positive relationship between all company divisions
- Ensures compliance with company Policies and Procedures, State, and Federal Regulations
- Maintains confidentially of all information related to patients, medical staff, finances and all other company and client information.
- Submits accurate invoices and expense reports timely to the appropriate department following company policies
- Adheres to all RCCS policies and procedures
- Additional duties as assigned.
EDUCATION AND/OR EXPERIENCE:
- Bachelor’s degree preferred but not required.
- Coding certification(s) required by one or more of the following bodies: AHIMA, RCCB, AAPC.
- Willingness to obtain additional industry specific certifications within one year of employment.
- Minimum three (3) years of experience as a consultant, auditor/educator, or compliance professional in healthcare.
- Minimum three (3) years coding job experience
- Previous experience managing employees
- Knowledge of coding, documentation, and reimbursement
- Knowledge of organization policies and procedures
- Knowledge of health care administration principles
- Knowledge of business office procedures as they relate to the healthcare industry
- Skill in exercising initiative, judgment, discretion, and decision-making to achieve objectives.
- Skill in identifying and resolving problems
- Ability to communicate effectively and professionally with all levels of staffing in health care provider organizations and business related organizations
- Ability to establish and maintain effective professional working relationships with all employees and clients
- Knowledge of CPT-4, diagnosis and HCPCS coding.
- 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. Experience working in MS Access is preferred.
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.