Provide client audits for all providers. The medical record or progress note will be audited for documentation to ensure compliance. Interacts with the practices non-provider and provider employees. Provides analysis to the providers for education.
Duties and Responsibilities
The duties include, but are not limited to:
• Audits medical record documentation to identify under coded and up coded services; prepares reports of findings and meets with providers to provide education and training on accurate coding practices and compliance issues.
• Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services.
• Interacts with physicians and other patient care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation.
• Interacts with providers and management to review and/or implement codes and to update charge documents.
• Generates reports as needed through various systems.
• Assist in provider education.
• 25% travel through the state of NJ.
• Performs miscellaneous job-related duties as assigned.
Qualifications or Education, Training and Experience
• High School diploma or GED
• Certificate in Medical Coding (AAPC) (AIHMA) or equivalent; at least 2- 3 years of experience directly related to the duties and responsibilities specified.
• Completed degree(s) from an accredited institution that are above the minimum education requirement may be substituted for experience on a year for year basis (doesn’t replace the necessary AAPC or AHIMA coding certification required).
Knowledge and Skills/Expected Competencies
• Proficient in Microsoft Office Suite software and Windows 10.
• Knowledge of auditing concepts and principles.
• Advanced knowledge of medical coding and billing systems and regulatory requirements.
• Ability to use independent judgment and to manage and impart confidential information.
• Ability to analyze and solve problems.
• Strong communication and interpersonal skills.
• Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation.
• Knowledge of current and developing issues and trends in medical coding procedures requirements.
• Ability to clearly communicate medical information to professional practitioners and/or the public.
• Detailed knowledge of medical coding systems, procedures, and documentation requirements.
• Ability to adapt and modify medical billing procedures, protocol, and data management systems to meet specific operating requirements.
• Ability to provide guidance and training to professional and technical staff in area of expertise.
Internal Number: 1201
About Consensus Health
Consensus Health was founded to empower both patients and physicians.
Our goal is to give patients the best possible experience—including the ability to see the primary care physicians and specialists of their choice.
To physicians we offer the benefits of ownership in a large multispecialty practice—and the rewards of remaining independent – including more time for patient care – and an improved quality of life.
Our experienced and award-winning management team has a proven track record of creating successful and profitable medical groups. By supporting physicians and allowing them to focus on patients, we help them deliver higher quality medical care and a better patient experience.
Through key partnerships with primary care providers and specialists, as well as insurance providers, we’re working to build the most comprehensive multispecialty network in the state. We aim to provide optimal care for patients, and long-term independence and work-life satisfaction for physicians.
In short, we’re creating a better healthcare system for everyone.