PROFESSIONAL CODING COMPLIANCE SPECIALIST Job at Riverside Medical Center
We Are Hiring!
At Riverside, everyday brings new and exciting challenges. You can expect an interesting environment where you’re part of making sure our organization is running optimally and safely, helping keep the community healthy. We provide the kind of paid training and opportunities that long-term careers are built on and we recognize hard workers who strive to make a difference. You will be able to succeed in our close-knit, safety-focused culture working together as a team. The careers we offer are meaningful because the work we do matters. Join us!
FTE: 1.000000
Shift: Days
Location: 401 BULIDING-LL - HYBRID
Summary:
- High School graduate or equivalent, bachelor’s degree preferred
- Three years current CPT/ICD coding experience in a medical office required. E/M experience
- Excellent computer, communication and interpersonal skills required as well as familiarity with coding software
- Strong computer and presentation skills (Microsoft Office)
- Independent, critical thinking and accuracy/attention-to-detail skill level needed
License or Certification Requirements:
- Valid coding certification AAPC/CPC (Certified Professional Coder) required
- AAPC/CPMA (Certified Professional Medical Auditor) within 2 years of hire
Responsibilities:
- Audit revenue cycle practices to ensure compliance and consistency among practices.
- Coding compliance resource and consultant for all physician and mid-level providers, company administrators and physician practice staff.
- Develop consistent professional coding processes across multiple physician practice locations.
- Develop curriculum to be used in orienting and educating physicians and staff to medical record documentation guidelines and standards and to diagnostic and procedural coding conventions and methodologies.
- Develop educational tools based upon the results of managed care audits, including practices to minimize service denials.
- Develop policies and procedures on coding compliance for RMG practices.
- Educate clinical and office staff on best practice coding functions.
- Implement coding reviews, create work plans based on the reviews and ensure that compliance issues and areas of risk are identified, documented, and addressed.
- Perform chart audit and formulate recommendations based upon the audit findings and communicate them to the appropriate personnel. Communication should include cited sources.
- Ensure timely response and accurate collection of data requested for regulatory audits. (i.e. ADR, RAC)
- Prepare and submit compliance reports to the compliance officer and Director of Revenue Integrity.
- Report billing issues to the Directors of Patient Financial Services, Revenue Integrity. Prepare and assist in recommendations for process improvements and corrections.
Essential:
- CERTIFIED PROFESSIONAL CODER
Essential:
- HIGH SCHOOL DIPLOMA
Riverside Healthcare is revolutionizing care using leading-edge technology to diagnose and treat patients. We are ranked top in the nation for performance in neurosurgery, orthopedics, and heart surgery and have also been named one of the nation's 100 Top Hospitals by Truven Health Analytics seven times. Riverside is nationally recognized for our specialty programs in obstetrics, trauma, oncology, rehabilitation, geriatrics, occupational health, psychiatric services, and treatment of alcohol and chemical dependency, as well as patient safety. We combine innovation and convenience at state-of-the-art facilities located in communities throughout the greater Kankakee area.
Riverside Medical Center proves that truly progressive medicine is being delivered in Chicago's southwest suburbs and East Central Illinois. Join a team that is not only concerned with providing the best care possible but also with offering a work environment of advancement and growth. Riverside is a place that embraces a culture where opinions count and dedications is respected, where superior performance is rewarded with competitive salaries and excellent benefits.
Other information:
Exposure/Sensory Requirements
Exposure to:
Chemicals:
Video Display Terminals: Average
Blood and Body Fluids: Minimal risk
TB or Airborne Pathogens: Minimal Risk.
Sensory requirements (speech, vision, smell, hearing, touch):
Speech: Needed for presentations/training, telephone communication, facilitate meetings, communication with residents, families, visitors..
Vision: Needed to read memos and literature, computer entry.
Smell: Helpful to note presence of electrical/fire safety.
Hearing: Needed for telephone communication, meetings, alarms and listening to employee concerns, emergency procedures.
Touch: Needed to write, do computer entry, filing.
Activity/Lifting Requirements
Average Hours per Week: 40+
Shift: Days
Percentage of time during the normal workday the employee is required to:
Sit: 60%
Twist: 5%
Stand: 10%
Crawl: 0%
Walk: 5%
Kneel: 5%
Lift: 10%
Drive: 15%
Squat: 5%
Climb: 0%
Bend: 5%
Reach above shoulders: 5%
The weight required to be lifted each normal workday according to the continuum described below:
Up to 10 lbs: Frequently
Up to 20 lbs: Occasionally
Up to 35 lbs: Not Required
Up to 50 lbs: Not Required
Up to 75 lbs: Not Required
Up to 100 lbs: Not Required
Over 100 lbs: Not Required
Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):
Carry equipment to activity areas, Usually 50 or less feet, carried waist high. Examples carrying chairs, boxes, table - waist high, lift resident to a standing position.
Maximum consecutive time (minutes) during the normal workday for each activity:
Sit: 60-90
Twist: 5
Stand: 10
Crawl: 0
Walk: 10-30
Kneel: 5
Lift: 5
Drive: 0
Squat: 5
Climb: 0
Bend: 5
Reach above shoulders: 5
Repetitive use of hands (Frequency indicated):
Simple grasp up to 10 lbs. Normal weight daily
Pushing & pulling 20#
Fine Manipulation: Computer entry, phone dialing, writing, using calculator, filing.
Repetitive use of foot or feet in operating machine control: None
Environmental Factors (Time Spent) :
Inside hours: 8
Outside hours : 0
Temperature: Normal Range
Lighting: Average
Noise levels: Average
Humidity: Normal Range
Atmosphere:
Special Hazards :
Protective Clothing Required: None
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