Department: Business Office SRH

Exempt: Yes

Schedule: DAYS

Position Type: Full Time

FTE: 1.000000

Base Wage: $ 31.77 to $ 47.66

Location: SRH Business Center

The information described in this job description has been designed to indicate the general nature of the work performed. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.

Other information:

Job Summary

We are looking for an experienced Medical Coder to audit and analyze our coding function and provide feedback to coders and clinicians regarding coding and documentation.

Essential Functions

The Coding Auditor/Analyst is responsible for auditing, training, consultation, and providing feedback to coders and clinicians regarding coding and documentation to ensure SRH receives appropriate reimbursement and conforms to applicable guidelines and regulations. Position advocates compliance with all third party billing and reimbursement requirements including, but not limited to, the requirements of Medicare and Medicaid programs. Serves as the coding subject matter expert for coders and providers. Performs audits utilizing an in-depth knowledge of ICD-10, CPT and HCPCS coding, Correct Coding Initiatives (CCI) and documentation guidelines. Provides training for all new coders and as needed when coding issues are identified or new procedures are initiated. Provides day-to-day support to coders responding to questions related to coding and documentation. Through the attendance of provider department meetings, provides coding and documentation education and training. Performs coding reviews for coders and providers based on areas of deficiency. Provides ad-hoc audits of coders and/or providers when requested. Supports the development and documentation of coding policies and procedures. Utilizes understanding of Practice Management system to recommend Master File changes to facilitate correct claims coding per carrier specifications. Analyzes charge review edit and denial trends related to coding to identify opportunities where additional training or system enhancement is warranted. Through collaboration with Medical Affairs Coding Compliance, ongoing dissemination of information to Providers, Coders, and Clinic Managers to inform about coding policies via email, memos and periodic meetings. Keeps Coding/Charge Capture Manager abreast of issues that arise. Participates in projects to enhance coding and charge entry functions clinic-wide Performs other related tasks as assigned. This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned.

Education

High school diploma or equivalent required. Knowledge of medical terminology and hospital staffing preferred.

Experience/Training

At least two years of CPT, ICD-10 coding systems and chart auditing experience preferred. Experience working in a medical office setting required, with demonstrated understanding of standard insurance reimbursement methodologies preferred. Experience educating physicians regarding coding, charting and other relevant processes, in an individual and group setting preferred. Knowledge of medical terminology and anatomy and ancillary tests/procedures

License/Certifications

One of the following coding credentials required: AAPC (CPC, CPC-H, or one of the relevant AAPC specialty-specific coding credentials). Certified Professional Medical Auditor (CPMA) required, or ability to obtain within one year of employment.

Other Skills

Strong verbal, written and interpersonal communication skills. Excellent organizational skills and strong attention to detail required. Proficient computer and office equipment skills. Must be able to proficiently utilize Microsoft Office and department specific applications to perform work, including electronic health records. Knowledge of health care regulations and standards as they apply to correct coding. Understands regulatory and organizational guidelines and remains aware of changes in the healthcare environment. Working knowledge of ICD-9-CM, ICD-10-CM, and CPT coding guidelines and conventions. Skills in efficient use of time, i.e. time management skills. Skills in analytics. Able to interpret documentation, billing, and coding guidelines. Able to organize work priorities and meet deadlines while handling large volumes of work. Maintains a professional and cooperative attitude with providers, co-workers, and employers. Able to maintain confidentiality of all compliance related information.

Physical Demands and Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for long periods of time; when working in office. Repetitive tasks such as typing, sitting, answering phones, and interacting with computers and computer systems most of the day is a function of the position. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to focus. This position requires working in an indoor, environmentally controlled environment when in the office.

Skagit Regional Health offers a comprehensive benefit package including medical, dental, vision, 457b/401a (retirement), long term disability, and paid time off to all employees holding an FTE of 20 or more hours per week. Eligible employees also receive sick time pay.