Coding & Compliance Specialist
Summary
Ensures accurate medical coding and billing compliance for a hospital system by auditing records, resolving discrepancies, and guiding staff/providers on documentation and payer regulations. Uses EMR systems and regulatory expertise to improve processes and reporting.
Schedule: Monday - Friday 8am -4:30pm
Required Job Specific Competencies:
- Demonstrates skills in customer service, communication, team building and problem solving.
- Demonstrates competency in all areas of hospital third party insurance billing including federal and state regulations.
- Demonstrates skill in proactively resolving problems, recommending, and implementing process changes.
- Demonstrates skill in communicating with patients, payer representatives and associates throughout the Health System.
- Coordinates and conducts periodic medical record audits for providers to assess compliance with coding (over/under coding, trends), billing, documentation, and payer regulations. Develops reports as directed. Reports findings to management and providers.
- Electronic Medical Record experience preferred
- Highly organized and detail oriented
Qualifications:
- CPC-A required, CPC or CPC-H preferred
- Excellent communication skills and ability to form collaborative partnerships across all service settings.
- Proficient in the use of Electronic Medical Records (EMR); ability to create reports on own and interface with EMR vendor to develop reports where none currently exist
- Extensive knowledge RBRVS and federal, state, and other payer regulations pertaining to documentation, coding (E&M, modifiers, critical care) and billing.
- Ability to analyze coding and actively question and guide providers and/or Billing staff as appropriate.
- Strong medical terminology background
- Competent in Microsoft Office products (Word, Excel, Outlook, PowerPoint). Self-directed, self-starter and able to implement new program
- Accepts responsibility and follows through on projects and activities.
- Ability to assimilate new information and technologies into daily work.
Education:
- CPC-A required
- CPC or CPC-H preferred
- Associates degree, preferred
Experience:
- 3-5 years of healthcare experience, preferred
- Billing Experience preferred
- Excellent public/patient relations and communication skills.
- Skills in using computers including Excel and Word required.
Pay Range: $20.00 - $25.00/hour
Starting Pay: Based on Experience
Thompson Health is an EOE encouraging individuals with disabilities, and veterans to apply.