Kettering Health.

  • Miamisburg, OH


  • Irreversible.

  • Full-time.
Summary

Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient centers serving southwest Ohio. We are devoted to changing the healthcare experience with top quality take care of every phase of life. Our service-oriented objective is in action every day, whether it’s by offering care in our centers, training the next generation of healthcare experts, or serving others through global outreach.

School Summary

Kettering Doctor Network

  • Our elite medical group utilizes more than 700 suppliers, consisting of doctors and advanced practice service providers, throughout the Greater Dayton and Cincinnati locations.
  • Our clients have access to a multidisciplinary expert group to fulfill all their health care requires. From medical care to brain and spinal column surgical treatment, we supply a substantial series of specializeds and know-how, in over 200 areas and 10 counties.
  • Working collaboratively throughout specializeds, we provide clients a team-based design of care in which the client is the most essential member of the health care group.

Responsibilities & Requirements

Duties:

  • Acts as the subject professional making sure professional svcs coding compliance, understanding of CMS billing guidelines and policies and functions as a professional svcs coding resource to appointed professional svcs coding specializeds. Manage and audit of professional svcs coding precision for designated professional svcs coding specializeds.
  • Shows understanding of CPT, HCPCS, ICD-10 and CMS NCCI modifies
  • Precisely evaluate documents in IMPRESSIVE EMR
  • Evaluation and research study pended and rejected claims referring to professional svcs coding, CMS NCCI modifies, and/or medical requirement requirements [CMS LDC/NCD and/or payer policy]
  • Identify academic chances for network professional svcs coding
  • Correspond with suppliers on pended claims to assist in resolution
  • Accountable for taking part in department objectives, KHN objective and policies
  • Interact properly with companies and expert coding expert
  • Research study, willpower, and react to issues prompt

Requirements:

  • High School Diploma or comparable
  • RHIT, RHIA, CCS, CCS-P, CPC or qualified specialized accreditation
  • 2 years previous experience in expert charge coding/billing

CPT, HCPCS, Modifiers, ICD-10, and CMS NCCI Edits

Medical Terms and Anatomy & Physiology

Computer System and IMPRESSIVE Applications

Outstanding spoken and written interaction abilities Charge Evaluation WQ

  • Evaluation, research study, and react to Charge Evaluation WQ relating to professional svcs coding, CMS NCCI modifies, and/or medical need requirement to help with resolution
  • Correspond and interact properly with companies on professional svcs coding, CMS NCCI modifies, and/or medical need requirement to help with resolution
  • Demonstrate understanding of CPT, HCPCS, ICD-10 and CMS NCCI modifies
  • Claim Edit WQ
  • Evaluation, research study, and react to Claim Edit WQ referring to professional svcs coding, CMS NCCI modifies, and/or medical need requirement to help with resolution
  • Correspond and interact properly with companies on professional svcs coding, CMS NCCI modifies, and/or medical need requirement to assist in resolution
  • Demonstrate understanding of CPT, HCPCS, ICD-10 and CMS NCCI modifies
  • Follow Up WQ [Denials]
  • Evaluation, research study, and react to Follow Up WQ relating to professional svcs coding, CMS NCCI modifies, and/or medical need requirement to assist in resolution.
  • Correspond and interact properly with companies on professional svcs coding, CMS NCCI modifies, and/or medical need requirement to assist in resolution
  • Demonstrate understanding of CPT, HCPCS, ICD-10 and CMS NCCI modifies
  • Compliance
  • Accountable for KHN Pro Svcs Coding compliance with CMS and other regulative and payer policies

Kettering Health.

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