Women's Care USA

  • Coding & Compliance Director

    Job Locations US-FL-Tampa
    Posted Date 2 weeks ago(11/5/2018 1:13 PM)
    Job ID
    2018-3485
    # of Openings
    1
    Category
    Billing/Revenue Cycle
  • Overview

    The Coding and Compliance Director is responsible for overseeing the Coding Auditor and Educator and Coding Managers. This position provides operational support to the Revenue Cycle Management Departments by overseeing the auditing and educating process along with coding and charge entry performed by CBO personnel. This position is also responsible for reviewing coding trends, benchmarking patterns, and providing education to all staff including providers. This position ensures coding compliance, along with benchmarking and best practices process across the departments. This position must train, mentor and educate managers, coding and charge entry specialist.

    Responsibilities

    Ongoing review of third party payer and government billing guidelines.

    Create an auditing process and facilitate implementation

    Perform bi-annual review of Medicare and Medicaid claims to ensure compliance with all government standards

    Oversee ongoing medical record audits for each provider to ensure coding and documentation compliance

    Implement best practices for coding and charge entry in conjunction with the managers.

    Educate staff, including providers, on changes in billing guidelines for third party payers, Medicare, and Medicaid

    Develop audit tools, a scoring system, and the billing compliance program to help identify issues and incorporate them as part of the compliance program

    Perform annual update of new, revised, and deleted CPT and ICD-10

    Conduct annual review of WCF fees in comparison to current year Medicare

    Provide continuing education for offices, staff including development of reference materials

    Provide coding and compliance updates

    Perform on site billing and coding training during new unit implementations

    Develop and implement a personnel development program to ensure continuing professional growth

    Perform other duties and functions as directed and/or requested

     

    Qualifications

    Bachelor’s degree preferred

    5 plus years experience in billing and coding

    Knowledge of third party payer and government billing guidelines

    Coding Certification through AAPC

    Experience with billing protocols and procedures

    Ability to develop and maintain relationships

    Excellent communication, professional, and organizational skills

    Computer literate including Microsoft Office programs

    Knowledge of practice management system 

    Customer/Client service orientation

     

    PREFERRED QUALIFICATIONS:

    Multi-Specialty Coding knowledge

    Bachelors degree preferably in business, healthcare administration, or related field a plus

    Knowledge of e-Clinical Works

    Travel required

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