A physician-led-and-owned healthcare delivery organization, Vituity offers integrated, acute care expertise in the areas of anesthesiology, emergency medicine,
Coding Compliance Analyst
Location
United States
Posted
24 days ago
Salary
$26 - $32 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Coding Compliance Analyst
Vituity
Role Description Performs chart assessments with focus on application and accuracy of CPT, ICD-10-CM and MIPS/QCDR codes utilized, including communication with other departments, as needed. - Performs reviews for payer specific coding application and makes recommendations or file appeals, as needed. - Assists with coding of confidential charts, as needed. - Communicates trends in errors or documentation concerns to the Coding Compliance Manager. - Participates in industry-related webinars and/or other conference calls, as needed, and summarize information. - Offers recommendations for coding program enhancement. - Reviews encounters and makes final determination of patient disputes, including communication by mail with patients, as needed. - Ensures compliance with local, state, and federal government requirements. - May be asked to travel for business purpose, not exceeding 5%. - Researches, interprets, and develops coding guidelines and methodology, including coder and client reference materials such as: Medicare, Medicaid, and workmen’s compensation guidelines for states we have not billed in, new practice lines and/or services, and new CPT codes, including possible addition of services not currently billed for. - Researches and interprets other commercial payer policies and provides guidance as needed. - Assists in reviewing information and applying periodic updates to RCM reference materials. - Evaluates literature, regulations, and payor policies and clarifies current code application and methodology, as needed. - Review and/or application of MIPS/QCDR measures. Qualifications - High School Diploma or GED equivalent required. - Two years’ minimum coding experience, or equivalent, to be able to apply correct CPT and ICD-10-CM codes in accordance with all Federal, State, and private payer statute and regulations; OR - Two years’ minimum billing experience with government payors, preferable Medicare and Medicaid. - Certified Procedural Coder (CPC) certification and/or Certified in Healthcare Compliance (CHC) certification highly desired. - Basic knowledge of pathology and etiology of disease, body areas and organ systems. - Knowledge of CPT and ICD-10-CM coding practices and/or knowledge of Medicare/Medicaid billing practices and appeal process. - Excellent communication and interpersonal skills, including conflict resolution. - Ability to communicate effectively in writing and verbally. - Computer skills including Microsoft Outlook Suite (Word, Excel, Outlook), with intermediate Excel and Word knowledge. - Ability to review literature and come to conclusions and make recommendations to coding management. - Ability to analyze new or ambiguous information, define the issue or problem and propose resolution. - Strong organizational skills and ability to meet deadlines. - Ability to handle a fast-paced, high production environment. - Strong consultation skills and the ability to seek out information and provide quality advice. - Strong research skills with ability to apply complex reasoning and analysis to identify best policy proposal or interpretation. - Ability to work independently, accomplish responsibilities timely, meet acceptable productivity requirements to ensure appropriate workflow. - Ability to maintain effective working relationships with all staff. - Ability to react to change productively. Benefits - Superior health plan options. - Dental, Vision, HSA/FSA, Life and AD&D coverage, and more. - Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6% plus discretionary profit-sharing contributions (eligible January following 18 months of service). - Generous paid time off starting 3-4 weeks’ annually. - Student Loan Refinancing Discounts. - Professional and Career Development Program. - EAP and travel assistance included. - Wellness program. - Purpose-driven culture focused on improving the lives of our patients, communities, and employees.
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