Coding & Compliance Specialist

United States·Canandaiguamid

Legal & ComplianceCompliance Specialist

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Quick Summary

Requirements Summary

Must have one of the following: CPC-A, CPC, or CPC-H Excellent communication skills and ability to form collaborative partnerships across all service settings.

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Legal & ComplianceCompliance Specialist

Demonstrates skills in customer service, communication, team building and problem solving.
Demonstrates competency in all areas of hospital third party insurance billing including federal and state regulations.
Demonstrates skill in proactively resolving problems, recommending, and implementing process changes.
Demonstrates skill in communicating with patients, payer representatives and associates throughout the Health System.
Coordinates and conducts periodic medical record audits for providers to assess compliance with coding (over/under coding, trends), billing, documentation, and payer regulations. Develops reports as directed. Reports findings to management and providers.
Electronic Medical Record experience preferred
Highly organized and detail oriented

Requirements

~1 min read

Must have one of the following: CPC-A, CPC, or CPC-H
Excellent communication skills and ability to form collaborative partnerships across all service settings.
Proficient in the use of Electronic Medical Records (EMR); ability to create reports on own and interface with EMR vendor to develop reports where none currently exist
Extensive knowledge RBRVS and federal, state, and other payer regulations pertaining to documentation, coding (E&M, modifiers, critical care) and billing.
Ability to analyze coding and actively question and guide providers and/or Billing staff as appropriate.
Strong medical terminology background
Competent in Microsoft Office products (Word, Excel, Outlook, PowerPoint). Self-directed, self-starter and able to implement new program
Accepts responsibility and follows through on projects and activities.
Ability to assimilate new information and technologies into daily work.