Clarify discrepancies in documentation and coding. Monitor coding, abstracting and data entry for accuracy with the use of various Meditech reports, and assign ICD-9-CM and CPT-4 codes to discharged inpatient and outpatient medical records, Monitors Medical Necessity and Denials, working with ancillary departments, coding staff, and physician offices for appropriate documentation, Monitors DRG maximization efforts to ensure optimal DRG and third party reimbursement, Generate and submit monthly reports to the Director of Medical Records, Oversee, train, and mentor coding staff, providing on-going in-service education on updates, revisions, and deletions of codes and coding guidelines, and correct coded information to ensure compliance with Rate Setting and other external data requirements, Conduct routine random audits of coding practices (inpatient and outpatient care) to ensure compliance with various documentation guidelines, coding principles and conventions, and assist in the departmental Quality Improvement/Coding Compliance processes and assisting the Coding Validator in the audit process, Act as a liaison to the Case Management, Patient Access, Patient Finance and Information Services departments to maintain a timely billing schedule, and act as a liaison to the Medical Staff with regards to coding, DRG and denial/appeal issues when necessary, Perform audit appeals process (RAC, MassPRO and Blue Cross), prepare all necessary records, reserve space, obtain necessary documentation for on-site review, appeal denials where appropriate, and maintain summary sheets on cycles, Consistently and fairly implements human resource policies, Maintains effective and appropriate staffing by monitoring employee turnover, overtime and absenteeism, and compliance with established Medical Center staffing standards, Evaluates performance and initiates personnel actions (merit increases, promotions, progressive discipline, termination ) in a timely manner to ensure maintenance of an optimal work force, Collaborates with Human Resources on the recruitment and selection of qualified employment candidates following all policies, guidelines and applicable laws, Communicates changes to staff in a clear and concise manner, providing written procedures and inservice education as needed Monitors progress and results of employees, giving constructive feedback and recognizing contributions. Must obtain RHIT or RHIA within 6 months of employment, Skills & Abilities: Basic knowledge of human anatomy, physiology, and medical terminology. Vast knowledge of medical terminology, procedures and billing nuances of general hospital health care. hours, Proficiency in Microsoft Excel, Word, VISIO & PowerPoint a plus, Knowledge of managed care regulations regarding patient type criteria and appropriateness of patient type statuses by healthcare professionals when admitting patients as OP, OBS, or IPs, Outstanding analytical and organization skills with attention to detail, Ability to interface with compliance and outside auditors, This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor’s diagnosis of disease, Set up new suppliers and new products; research and analyze current product and supplier data files for set up decisions, Validate new supplier legal documentation for adherence to current guidelines, Validate new product certificates for product claims, Communicate with supplier and/or broker for needed documentation or questions relating to the completion of new item set up, Establish system wholesale and SRP based on margin guidelines for product category or group, Create new brands, headers and sub headers as needed for UNFI publications and web site product listings, Create new product promotional form and distribute, Maintain and save new supplier and product information to assigned locations, Update department spreadsheets with new supplier information and price/freight information, Process cost and freight changes following company margin guidelines, Distribute supplier and product documentation, Research and resolve cost discrepancies and product issues with inventory control, customer service and SRM, Communicate completed items and current issues to SRMs, Fax, photocopy, scan and run reports from the business system and MRS, Perform other administrative and clerical functions as needed, Create and distribute reports as assigned, Thorough knowledge of Company products and services, Understanding of related computer applications, Knowledge of advertising, printing, and print production processes, One to two years of experience in marketing communications, sales, advertising, or related fields, Excellent proofreading skills and command of the English language, Well organized and able to meet deadlines, Ability to work in a team environment without supervision, Ability to use office equipment such as fax, copier and scanner, Monitoring, continuous quality improvement, Timely and accurate delivery of coding services, A minimum of 5 years of experience in hospital, healthcare operations, Coding supervisor or management experience with either Inpatient, Outpatient, Radiology, or Emergency Department coding, A technical understanding of healthcare industry information systems (EMR and Encoder systems), Must be able to travel up to 20% for this role, Experience working for a 3rd party coding vendor and personnel management, Subject matter expert in at least one specialty, e.g., oncology, gynecology, surgical coding (not including primary care procedures) and infusion coding including chemotherapy and infusions involving multiple drugs, Assigns CPT and ICD codes in cases of moderate to high complexity, Reads, interprets and assigns CPT codes from provider documentation, e.g., infusion record or operative report, Researches and analyzes coding and payer specific issues, Processes charges on a timely basis and communicates with team members and practice management on an ongoing basis, Communicates with providers related to coding issues that are of moderate to high complexity. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Educate these populations in a large number of topics including introductions to the ICD-10-CM/PCS systems, documentation specificity required by ICD-10, documentation improvement, general ICD-10 awareness, ICD-10-CM/PCS coding, and other ICD-10 topics. Working knowledge of … Identifies potential solutions where documentation problems occur. Take the time to review it. Re-trains as necessary, 7 Apply official coding guidelines and regulatory standards to performance of coding medical records so that CHN meets the ethical and legal standards set by regulatory and governing agencies, 8 Review medical record documentation so that coding substantiates appropriate reimbursement of accounts receivables. Must work well independently and be prepared to make crucial decisions without asking questions, Review new asset information, applying knowledge of various security types to interpret and record the security on the asset file, Industry Knowledge - Knowledge of financial instruments, valuations business & regulations, Awareness of securities data, corporate actions, pricing or funds, Working knowledge of Bloomberg, Reuters, FT Interactive Data and Telekurs, Business or financial services qualification (Advantageous), Conducts physician chart audits (including research and presentation). Including face to face interaction and education with providers, Applies modifiers and appropriate ranking to encounters with multiple codes, Reviews medical records of high complexity to identify the appropriate principal diagnosis and procedure codes, all other appropriate secondary diagnoses and procedure codes. Consistently meet established deadlines with minimal supervision, Assure the assignment of complete, accurate, timely and consistent codes by the medical coding unit. Respond promptly to any complaints in accordance with policy in employee handbook, Prefer 1 year of healthcare coding experience, Current Certified Professional Coder license or higher equivalent, Strong knowledge of CMS Risk Adjustment requirements, Requires comprehensive knowledge of medical, administrative, ethical and legal requirements and standards related to healthcare delivery and privacy of protected patient information, Working knowledge of: ICD-10-PCS, facility coding, ProFee coding, DRG, HCC and APS, Ability to audit inpatient and/or outpatient medical records using ICD-9/10-CM and CPT-4 coding rules and guidelines, Understanding and ability to apply anatomy and physiology as related to medical coding, Ability to manage multiple projects and meet deadlines, Report writing skills preferred, advanced skills with Microsoft applications (Word,excel, access), Develops, implements and maintains a training program for new Revenue Cycle Specialist and Revenue Recovery Analyst staff, Consults with operational leaders regarding the development of the Revenue Cycle Specialist and Revenue Recovery Analyst training program, Develops instructional objectives, based on the skills and knowledge, which make up the course content for new staff or changes to existing systems/processes, Develops and delivers direct training to new and existing employees, Analyzes organizational, learner and job needs to determine performance requirements, Designs and develops competency measurements to ensure skill and knowledge base of staff meets standards. 456 123 way to get hired security of medical necessity requests state death transcripts to other states HIPPA rules for... 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