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JOB SUMMARY:

The position is responsible for coordinating provider coding and compliance activities and outcomes within Concentra Health Services, including but not limited to revenue optimization, level of service coding and diagnosis coding.

MAJOR DUTIES AND RESPONSIBILITIES:

PrimaryFunctions:

1. Provider/Coder support, education and training related to revenue optimization, quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards.
2. Perform compliance audits for designated provider/coder centers consistent with established audit protocol.
3. Coordinate with Zone Medical Leadership in development of provider/coder training plans and for active support in the training process.
4. Organize and schedule periodic training as indicated from audit results, denial and down coding trends, level of service reports, etc. and/or as requested by medical leadership or CBO management.
5. Monitor Coding and State Workers Compensation changes to ensure that most current information is available.
6. Provide coding support to CBO as requested.
7. Other duties as may be assigned.

EDUCATION/CREDENTIALS:

High School

Associates degree or Bachelors degree or equivalent experience

CPC or CCS-P coding certification Required

JOB RELAVENT EXPERIENCE:

Five years progressive healthcare billing, coding and auditing experience including provider training and presentation.

JOB-RELATED SKILLS/COMPETENCIES:

Auditing

Basic computer skills PowerPoint, Excel, Word

Strong process management skills

Familiarity with state specific workers compensation regulations

Training and presentation skills