Director Medical Coding and Chart Audit Services HCS

Job Description

Salary: 72,618.00-108,927.00 USD

Facility: Administrative Regional Training Cntr

Shift: Shift 1

Status: Full Time FTE: 1.066667

Bargaining Unit: Catholic Health Emmaus

Exempt from Overtime: Exempt: Yes

Work Schedule: Days

Hours:

Monday to Friday: 8 - 5

Summary:

Responsible for the overall efficient operation of CHS Outpatient Coding and Private Client Medical Coding and Chart Audit Services.

Responsibilities:

SKILL AND EDUCATIONAL REQUIREMENTS (MINIMUM):

The successful candidate will have: A thorough understanding of Current Procedural Terminology (CPT) codes, International Classification of Diseases (ICD-10) diagnosis codes and appropriate modifier use. Experience with AHA Coding Clinic and CPT Assistant as resources

• Requires extensive knowledge of Medicare and Commercial Payers coding and billing policies. They will ensure documentation compliance with governmental and third-party Payer regulations
• Knowledge of National Correct Coding Initiatives (NCCI) edits, National and Local Coverage Determination Policies (NDC and LDC) and Medically Unlikely Edits (MUE)
• Strong research capabilities with respect to Medical procedures and technology; and an excellent knowledge of Medical terminology
• Excellent computer skills- Word, Excel, multiple EHR systems and electronic encoders
• Excellent communication skills- Daily communication with Clients as well as supervising a talented and diverse team of Medical Coders
• Works well in a team environment and has the capability to multi-task several responsibilities
• Recognizes and protects the confidentiality of all patient and employee information according to HIPAA policy.
• Interfaces well with external and internal Professionals at all levels- Medical, Legal, and Clerical

EDUCATION

• Minimum of Bachelor's degree in a related health or science field with 5 -10 years of Medical Coding experience
• Medical Coding certification through American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is also required with multiple certifications a plus

EXPERIENCE

• 5- 10 years of multi-specialty coding with supervisory experience

KNOWLEDGE, SKILL AND ABILITY

• Resolves insurance denials through the research of Payer policies, NCCI edits, and coding guidelines
• Updates and maintains Payer policies specific to each Client along with databases of coding guidelines
• Educates Clients and staff on correct Coding guidelines and provides annual CPT, ICD-10, and vaccine updates
• Supervises and mentors the Medical Coding Team to ensure they provide Clients with the highest level of Medical Coding service
• Responsible for overseeing all audit activities- internal, external, and third-party prospective and retrospective payer audits including Federal and State agencies. Ensures compliance of CPT and Medicare regulations with respect to Coding and documentation guidelines

WORKING CONDITIONS:

• Normal heat, light space, and safe working environment; typical of most office jobs
• Long periods of sitting