Medical Claim Compliance Corporation is changing
how healthcare is delivered, processed and paid. Physicians can focus on
quality care for patients and ensure accurate, complete documentation and
coding. What makes MCC special is our dynamic team.
for oversight of the coding department, developing, implementing, and
maintaining a system-wide quality management plan and facilitating improvement in
overall quality, completeness, appropriateness and accuracy of documentation
and coding for medical encounters in various clinical settings ranging from
hospital systems to individual providers. The Director will head up the review process
for documentation of providers, coding and provide education and improvement
bench marks in all areas of documentation and coding. This individual also
develops and maintains policies and procedures that will improve and support
the provider documentation and coding practices within the company and with
participating providers to ensure timely, accurate and complete documentation
and coding. This includes management and oversight of coding associates day to
day operations, audits, hiring, termination, evaluations, etc. The Director
utilizes project management skills, clinical knowledge, and understanding of
documentation and coding requirements to improve day to day operations,
processes and compliance.
direction for professional documentation and coding related activities, audits,
education, and monitoring.
day-to-day oversight of operations for the department responsible for
Hierarchical Condition Category (HCC) / Clinical Quality Coding, risk
adjustment, and reporting measures.
workflow improvements and standardization to increase efficiency and accuracy
of documentation and coding for all services and providers
as a liaison between providers and coders to resolve documentation and coding
implement, and maintain a formalized review process for coding and
documentation compliance, including a formal audit process and quality control
performance standards and conduct evaluations
communicates with providers, must be able to speak about clinical encounters to
include, evaluation and management based on documentation with both providers
timely feedback to providers/coders and take corrective action to ensure
provider audit programs to evaluate compliance with policy, coding (ICD-10, CPT
and HCPCS), billing (NCCI, etc), and regulatory (CMS) requirements.
with ICD-10 and HCC coding as well as E&M and all professional coding
guidelines for large multi-specialty provider groups.
Stay abreast of
governing regulations and will be responsible for providing coding and
compliance related education.
Certifications (RHIA, RHIT, CCS, CCS-P, CPC)
years of healthcare experience required
years of hands on professional coding experience large multi-specialty group
years of experience assisting provider documentation and managing physician
knowledge and experience with Medicare guidelines and authorization
working knowledge of ICD coding classification systems, CPT and E&M guidelines
knowledge of coding for third party payers including CMS guidelines and
of HIPAA, JCAHO, and other compliance requirements
of health information systems and database technology
organizational and project management skills Demonstrated team development and
analytical and problem-solving skills
communication and presentation skills
computer skills (i.e., word-processing, spreadsheets, and menu-driven software)
ability as a leader
degree in a health information management or other healthcare-related field
degree in related field preferred