PURPOSE OF YOUR POSITION
The Billing and Coding Compliance Associate works under the supervision of the Manager of Coding Compliance and will have direct communication with leadership from all EMSO practice Offices (including Management and physicians) and Hospital based practices that perform professional coding. They will also work collaboratively with, Health Information Systems, Coding, Accounting, Patient Accounts, Compliance and Finance. The Billing and Coding Associate will be responsible for the annual risk analysis and audit planning process for coding of professional services, in conjunction with the overall ECH/EMSO Compliance program as maintained by the ECH Corporate Compliance Director.
GENERAL INFORMATION
This position ensures front-end coding procedures are followed and charge entry based upon accurate coding is performed compliantly. Implements coding policies and procedures to ensure accurate and defensible support for the billing and reimbursement functions including compliance with contractual, state and federal requirements. Communicates systems and coding information timely to operations, physicians, and staff and audits compliance and coding systems policies, procedures, and regulation and develops educational programs and hands on sessions to enhance staff performance.
PHYSICAL DEMANDS
Work very frequently requires walking to various areas of the hospital and prolonged sitting (51-80% of work time).
Work occasionally requires lifting charts and other materials up to 10 lbs (6-20% of work time).
Must be able to see and hear, or use prosthetics that will enable to these senses to function adequately to assure the requirements of the position are fully met.
ENVIRONMENTAL CONDITIONS
Generally good working conditions with some discomfort due to noise, crowded conditions or frequent interruptions (more than 80% of work time). ?Universal Precautions may apply.
QUALIFICATIONS
Requires completion of a formal education program such as an RHIT, nursing or clinical program or equivalent with knowledge of medical coding and attainment of CPC or CSS-P certification within one year of hire; or current CCS-P (AHIMA) or CPC (APCC) certification.
Prior experience in an outpatient setting or with coding or medical records is preferred. Requires ability to audit physician documentation and meet with physician providers to discuss audit outcomes. Requires knowledge of auditing office encounters for ICD-10 and CPT correct code assignment and ensuring appropriate provider documentation to support billable services. Requires knowledge of medical terminology, PC applications such as Excel/Word; reimbursement regulations and CPT, ICD 10 and HCPS coding. Requires keyboarding skills, effective organizational and interpersonal skills and the ability to communicate effectively.
Requires ability to prioritize responsibilities; ability to handle multiple activities efficiently and effectively; ability to handle stressful or busy situations; ability to communicate effectively in all situations; requires knowledge of contractual insurance plans and procedures. Requires knowledge of and compliance with attendance, punctuality and personal appearance policies.
Pennsylvania state police criminal record check, child abuse history clearance and an FBI criminal history check required.
Work requires the ability to effectively present training to physicians and office staff in a classroom setting, or one-on-one using PowerPoint and other training materials.
Work requires intermediate computer literacy skills and keyboard proficiency to operate in multiple windows and manipulate files. Work requires use of auditing software to measure accuracy of physician coding. Work requires intermediate skills in Microsoft Word and email.
Work requires interpersonal skills to communicate with team members, clinical staff, physicians, and auditors (51-80% of work time).
Work requires analytical ability to analyze charts and interpret data from diverse sources to identify solutions. Must be able to follow and evaluate standard methods, procedures and policies to ensure quality patient care (51-80% of work time).
Work requires mental and visual focus requiring mental application and attention to detail. Work is performed under tight deadlines, must possess excellent time management and functional organizational skills to manage a variety of tasks in a short period of time (21-50% of work time).
Evangelical Community Hospital
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