What are the responsibilities and job description for the Coding & Payment Compliance Specialist position at FFAM 360 Staffing?
Coding & Payment Compliance Specialist
- Position Summary
This position is responsible for ensuring coding and payment accuracy for outpatient hospital services . The Coding & Payment Compliance Specialist must be able to assign HCPCS, CPT codes and modifiers to outpatient encounters including emergency department visits, clinic visits, oncology treatment visits, recurring outpatient therapy and infusion center visits, diagnostic exams and testing, and laboratory reference accounts. The Coding & Payment Compliance Specialist serves as a liaison to clinical departments, Health Information Services (HIM), Physician Revenue Cycle and Pt Financial Services (PFS) to resolve claim edits and line item denials. The position is responsible for reviewing and resolving charge line item denials and identifying opportunities to prevent avoidable denials. Attention to detail is required for accurate capture of data elements, knowledge of coding and billing regulatory guidelines, and billing rules, commitment to ethical and compliant coding practices.
Associate's degree in Health Information Administration or similiar Healthcare related degree - Preferred
3-5 Years Coding, Healthcare Billing, Claims Processing, Denials Management, Payment Processing or comparable experience - Required
Certification by American Health Information Management Association (AHIMA) CCA, RHIT, RHIA, CCS; or certification by the American Academy of Professional Coders (AAPC) CPC or COC or comparable medical coding certification - Required
Accurately reviews and resolves charge line denials to ensure proper billing and coding of outpatient hospital services for the health system. Collaborates with clinical departments, PFS, HIM and other revenue cycle departments to ensure appropriate rebilling of claims for denials, when appropriate. Identifies and collaborates with others to develop workflow and process improvements to prevent claim denials and incorrect payments
Visit our website www.ffamstaffing.com to learn more about our organization. As a member of our team, you will benefit from free job placement and services including immediate access to FFAM 360 Staffing available job openings, resume review and critique, and interview preparation with valuable information about the culture of potential employers. We also offer referral fees for any candidates you refer and place with our clients.