|Employer:||Conifer Health Solutions
|Skills:||Strong leadership and communication skills,problem solving and analytic,Ability to build and maintain team’s dynamics,al abilities; good knowledge of medical records systems,Advanced knowledge of ICD-10-CM,and CPT and HCPCS coding principles and rules,Advanced knowledge of RVU classification and reimbursement structures,Advanced knowledge of the functions of physician offices,medical clinics,and third-party medical companies,Experiance managing of offshore coding vendor operations,including vendor-specific understandings of processes,technologies,strengths,and opportunities for improvement
|Required Certifications:||CPC,RHIA or RHIT,CCS-P
|Required Experience:||5 to 7 years
|Preferred Experience:||8 to 10 years
|Location:||7624 Warren Pkwy Frisco 75034, TX, US* Note: This listing is for a remote position
ESSENTIAL DUTIES AND RESPONSIBILITIES
Include the following. Others may be assigned.
- Directs daily Coding Quality operations to SOW requirements and client expectations. Escalates potential coding quality trends and concerns to Conifer leadership and Compliance, where appropriate
- Continually assesses and improves the business unit’s financial and operational performance through data analysis and implementation of sustainable performance improvement initiatives.
- Works proactively and collaboratively with Procurement, Coding Compliance and other stakeholders to ensure that the coding quality of all Conifer third-party vendors meets or exceeds Conifer coding quality standards,
- Interfaces directly with internal and external clients for reporting responsibilities, prepares all necessary periodic reporting for clients and Conifer governing bodies, ensures compliance with the Guidance is being upheld in every respect regarding billing, coding and claims submission,
- Serves as a subject matter expert and resource for information and clarification on accurate and ethical coding and auditing processes and demonstrates a thorough knowledge of coding guidelines, governmental regulations, and third party billing requirements and is able to compare/contrast the guidelines/rules/regulations in order to discern which apply to the audit being performed. Interprets the often complex clinical content of a patient record including the most complicated medical diagnoses and surgical procedures.
FINANCIAL RESPONSIBILITY (Specify Revenue/Budget/Expense): N/A
- Provides input regarding departmental budget specific to area of responsibility.
- Reviews and approves expense reports for direct reports.
If direct report positions are listed below, the following responsibilities will be performed in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
Coding Quality Auditors
Coding Quality Senior Auditor(s)