NeighborMD.

  • Sarasota, FL


  • Permanent.

  • Full-time.
Essential Job Duties and Responsibilities:

  • Under the direction of the Director of Danger Change & Quality, and following a pre-determined or assigned audit schedule, supply an evidence-based audit of all internal organizational threat modification & charge for service coders.
  • Utilizing CPT and ICD-10, HCPCS II, service provider documentation and other approved resources, assess the appropriate task of treatment, modifier and medical diagnosis codes to professional services in order to verify precision and compliance. All coders should satisfy a minimum of 95% accuracy.
  • Collate, transfer and analyze all auditing results to catch and highlight threat issues, revenue leakage and instructional opportunities.
  • Offer coder feedback, initial and continuous education and training, and technical support in concerns to proper clinical documentation standards, service selection, charge capture and prompt submission, healthcare information accuracy and coding principles.
  • Based upon feedback from health insurance retrospective audit results, and precision expectations as determined to preserve appropriate coding standards, collaborate the educational chances for the appointed internal organizational threat adjustment & cost for service coders in concerns to the medical and legal elements of expert coding and documentation requirements.
  • Help with establishing and carrying out suggestions for changes in policies and procedures appropriate to correct and certified coding.
  • Function as a resource for coding staff and administrative personnel relative to technical guidance on expert coding concerns.
  • Stay current with all coding changes and updates through regular research and verification.
  • Perform other tasks as assigned by Director of Threat Modification & Quality.

Qualifications:

  • 3-5 years E&M coding/auditing experience in any medical specialized.
  • 3-5 years ICD-10/ danger modification coding & guideline experience.
  • AAPC CPC and CRC certifications (needed).
  • Ability to appoint, sequence and verify all CPT, ICD-9, ICD-10- CM, HCPCS codes with proper modifier use (required).
  • Working knowledge of CCI edits and other regulative guidance (needed).
  • Capability to develop, implement and provide and evaluate coding education strategies utilizing a range of methods to private coders & coding group.
  • Understanding of Health care insurance coverage guidelines as relevant to correct coding initiatives is necessary.
  • Threat adjustment & Medicare advantage plans experience (needed)

Unique Skills:

  • Need to have good working knowledge of Microsoft Office and PowerPoint.
  • Experience in dealing with numerous reports, spreadsheets and charts in an Excel format is needed.
  • Must be able to work within a pre-determined schedule, and be able to satisfy deadlines regularly.
  • The ability to operate in a collaborative way with coding staff, administrators and senior leadership to determine team requirements and prioritize workflow.
  • Organizational abilities, self-motivation, and the ability to work individually with minimum supervision is essential.
  • Experience in utilizing medical billing software and an electronic medical record is needed. Next Gen Practice Management/EMR System software application experience is extremely wanted.
  • Must have the capability to research and examine information, draw conclusions and solve problems, check out, analyze and use policies, treatments laws and guidelines.
  • Needs to have the ability to check out and analyze medical treatments and terms.

Accreditation:

  • CPC, CRC required, additional specialized certifications highly chosen.
  • CPMA or other nationally recognized medical auditing is a plus.

Note: This description indicates, in basic terms, the type and level of work carried out and obligations held by the team member( s). Duties explained are not to be analyzed as being extensive or specific to any individual team member.

No Third Party Agencies or Submissions Will Be Accepted.

Our company is devoted to producing a diverse environment. All qualified applicants will get consideration for work without regard to race, color, religious beliefs, gender, gender identity or expression, sexual orientation, national origin, genetics, impairment, age, or veteran status. DFWP

Opportunities posted here do not produce any suggested or express employment contract between you and our company/ our clients and can be altered at our discretion and/ or the discretion of our clients. Any and all information might change without notice. We reserve the right to solely figure out candidate suitability. By your submission you consent to all terms herein.

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