|Specialties:||Long term care, primary care, mental health, optometry, audiology, podiatry
|Required Experience:||5 to 7 years
Essential Duties and Responsibilities:
1. Coding/Auditing and Quality Expectations:
This key result area includes the following responsibilities:
- Comply with all legal requirements regarding coding procedures and practices
- Conduct audits in accordance with adopted audit programs to ensure documentation/billing is accurate and precise
- Conduct training and education to employees on correct documentation and coding/billing of claims
- Ensure that all codes are current and active
- Maintain up to date on all rules and regulations governing coding, billing and documentation
- Maintain working knowledge of medical terminology, anatomy and physiology necessary
- Communicate with providers regarding, treatments, tests, documentation etc. to validate accurate billing and coding.
- Collaborate with billing department to ensure all encounters are satisfied in a timely manner
- Review denials report to improve future processes/claims status
- Submit statistical data for analysis and research by other departments.
- Meet daily audit production
- Observe quality of service and best practices standards as described. In the employee handbook and any applicable agreements
- Be knowledgeable of and adhere to Eventus WholeHealth standards, policies and procedures. Assist in the creation of new standards, policies and procedures.
- Maintain patient confidentiality at all times. Agrees to abide by and be knowledgeable of HIPAA rules and regulations.
- Have accurate and precise attention to detail.
- Maintain the ability to multi-task, prioritize and manage time efficiently.
- Perform additional duties as assigned by supervisor.
2. Customer Service Guidelines:
This key result area is achieved by adherence to customer service and facility objectives below:
- Establish and maintain open and positive communications. Provide verbal and/or written instruction or feedback when needed.
- Conduct self in a professional manner at all times.
- Communicate effectively with insurance companies about coding errors and disputes
- Provide education to improve auditing and compliance scores for providers, leadership team and medical assistants
- Commitment to high level of customer service
- Have the ability to work independently or as an active member of a team
- Be goal oriented, organized and a team player
3. Maintaining Eventus WholeHealth compliance with applicable federal and state rules and regulations.
This key result area includes the following responsibilities/skills/qualifications:
- Be aware of and adhere to all legal and regulatory agencies' rules and guidelines and professional ethical standards. Comply with all regulatory agencies governing health care delivery.
- Monitor and report on federal state rules and regulations that may affect Eventus WholeHealth.
- Collaborate with necessary departments (HR, Quality Assurance, Internal Audit, Legal, Finance, Clinical, Operations etc) to direct compliance violations to appropriate existing channels for investigation and resolution.
4. Education and Experience.
- High school diploma or equivalent; Bachelor’s degree in related field preferred
- CPC by AAPC or AHIMA license; meet state licensure requirements
- Maintaining appropriate licensure and/or registration.
- Minimum 5 years’ certified medical coding experience in ICD-10 and CPT codes and procedures
- Maintain coding certification and attend in-service training as required
- Have strong computer skills in data entry, coding and knowledge of electronic medical record software, Microsoft Office Suite including superior proficiency in Excel
- Possess excellent verbal and written communication skill
ABOUT EVENTUS WHOLEHEALTH
Eventus WholeHealth, formerly OnsiteCare, was founded in 2014 to provide physician-led healthcare services for residents and patients of skilled nursing and assisted living facilities. With our highly-trained team of physicians, psychiatrists, nurse practitioners, physician assistants, psychotherapists, podiatrists, optometrists, audiologists, and support staff, our comprehensive, evidence-based model provides collaborative interdisciplinary care with the seamless and vital integration of a wide range of specialties. Our differentiated approach not only empowers the facilities to reach their own goals and objectives but also ensures better patient outcomes. For more information, please visit www.eventuswholehealth.com