SummaryLeads the team of coding integrity analysts. Provides documentation and coding advice related to Medicare, CMS regulations, and third-party billing requirements to the staff of LVPG. Serves as a resource to the organization for coding as it relates to professional fee billing. Oversees relevant edits in billing system to ensure accurate billing to all payers in a timely manner.
Job Duties- Manages critical data analysis; conducts research on complex documentation and coding issues and assimilates data.
- Conducts coding data analysis on outpatient services billed by providers with the intent on billing/reimbursement outcomes.
- Maintains the coding integrity for professional fee services rendered in facility and non-facility settings.
- Tracks and trends data for recommendations of workflow and process changes.
- Orchestrates communications for streamlined processing of payor rejection trends to expedite processing of accounts receivables.
- Serves as a resource with regard to the rules and regulations for proper coding.
- Assists revenue cycle with onboarding coding processes for new practices or major coding changes within an existing practice.
- Analyzes coding trends/issues and communicates with appropriate staff for educational purposes.
Minimum Qualifications- High School Diploma/GED or
- coding curriculum to include medical terminology, A&P, ICD-10, and coding guidelines.
- 3 years experience in professional fee coding/auditing in a multi-specialty environment.
- Knowledge of medical terminology, anatomy, physiology, and pathophysiology.
- Knowledge of CPT & ICD-9/ICD-10 CM coding classification systems, regulatory agency requirements, health care statistics computation, and accounting principles.
- Ability to multitask, identify areas of opportunity, and articulate and facilitate changes.
- Ability to prioritize tasks to expedite AR processing.
- Builds strong relationships with co-workers to partner for a better outcome.
- Knowledge of practice management system, EMR, and MS office applications (Word/Excel/Access).
- CCS-P - Certified Coding Specialist-Physician Based AHIMA - State of Pennsylvania Upon Hire or
- CPC - Certified Professional Coder - State of Pennsylvania Upon Hire
Preferred Qualifications- Bachelor's Degree in healthcare related field.
- 5 years experience in professional fee coding/auditing in a multi-specialty environment and
- 3 years of Accounts Receivable background.
Physical DemandsLift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.
Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.
Work Shift:Day Shift
Address:1200 S Cedar Crest Blvd
Primary Location: REMOTE IN PENNSYLVANIA
Position Type:Remote
Union:Not Applicable
Work Schedule:Monday-Friday; 8:00a-4:30p
Department: 
