This position is responsible for providing ongoing coding, documentation and compliance education to providers and their office staff. They are then responsible for monitoring coding and documentation performance through random chart audits and regular meetings to communicate findings with providers and staff; follow up as necessary (additional reviews, analysis of benchmarking profiles, etc.). The position must also provide continual coding and payer updates and research coding issues that will arise.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- (35%)* Orientation of new providers and staff (including locum tenens and new residents); ongoing review and training for up to six (6) months.
- (25%)* Conduct provider (physician and non-physician) and staff education on an ongoing basis. Once per month minimum. Education will include formal small group presentations.
- (25%)* Responsible for reviewing notes related to patient or payer complaints/concerns related to evaluation and management coding as well as patient requests for denials on services provided at the facility. After review, responsible for timely communication to the patient, payer and physician (if needed) to address their concern.
- (15%)* Conduct bi-annual chart audits, 1-2 week pre-review process for all providers, provide feedback and education on outcome of reviews and the Work Relative Value Unit (WRVU) impact.
OTHER DUTIES AND RESPONSIBILITIES:
- Complete audits of Office Of Inspector (OIG) focused areas for review as needed for Corporate Compliance.
- Semi-annual monitoring and analysis of utilization benchmark reports to Centers for Medicaid and Medicare Services (CMS) norms.
- Code difficult cases at the request of providers. July 12, 2021
- MidMichigan Health is a technology-driven organization and employees need to demonstrate competency in Microsoft® Windows. An employee may be required to participate in further learning opportunities offered by MidMichigan Health.
REQUIRED CERTIFICATIONS AND LICENSURES
- E/M CODER – CPC, CCS, CCSP, RHIT, OR RHIA
- Essential – Y Equivalent Experience – One of the following certifications are required: Certified Professional Coding (CPC) certificate, Certified Coding Specialist (CCS) certificate, or Certified Coding Specialist – Physician Office (CCS-P) certificate
- Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) preferred.
- Education: High School Diploma or GED
EXPERIENCE, TRAINING AND SKILLS
- Four (4) years experience in the medical field is preferred.
- Two (2) years physician coding and billing experience is preferred.
- One (1) year with direct physician contact preferred.
- Strong interpersonal, written and communication skills required.
- Being an effective educator, self-start and highly organized is required. Ability to exercise initiative and judgment is required.
- Knowledge of medical terminology and anatomy.
- Knowledge of Word, Excel and PowerPoint is preferred.
PHYSICAL/MENTAL REQUIREMENTS AND TYPICAL WORKING CONDITIONS:
- Exposure to stressful situations, including those involving public contact, as well as, trauma, grief and death.
- Able to wear personal protective equipment that includes latex materials or appropriate substitute if required for your position.
- Is able to move freely about facility with or without an assisted device and must be able to perform the functions of the job as outlined in the job description.
- Overall vision and hearing is necessary with or without assisted device(s).
- Frequently required to sit/stand/walk for long periods of time. May require frequent postural changes such as stooping, kneeling or crouching.
- Some exposure to bloodborne pathogens and other potentially infectious material. Must follow MidMichigan Health bloodborne pathogen and TB testing as required.
- Ability to handle multiple tasks, get along with others, work independently, regular and predictable attendance and ability to stay awake.
- Overall dexterity is required including handling, reaching, grasping, fingering and feeling. May require repetition of these movements on a regular to frequent basis.
- Physical Demand Level: Sedentary. Must be able to occasionally (0-33% of the workday) lift or carry 0-10 lbs.