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Job Details

Coding Auditor and Trainer

Company name
Saint Anne's Hospital

Location
Boston, MA

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Job Details: Certification is required. 3-5 years experience is required. Customer service skills are required. Experience is required. Summary: Responsible for training in CPT assignment for on-boarding physicians and mid-level providers; auditing new providers as described per policy and re-educating as needed. Audit and educate coding staff as necessary. Reviewing and validating a variety of charges generated from the providers. Performs in accordance with the policies and procedures. Follows standards for ethical business conduct. Conducts self as a positive role model and team member. Participates in facility committees, meetings, in-services, and activities as requested. Responsibilities: \u2022\u00a0Collaborate with other departments to resolve billing problems related to coding, including those stemming from CCI edits and the outpatient code editor (OCE). \u2022\u00a0Perform coding, documentation, and billing audits in focus areas as assigned, including summarizing audit findings, and proposing recommendations. Oversee implementation of audit recommendations as appropriate. Perform follow-up audits and reviews to monitor and validate ongoing compliance with applicable rules and guidelines. \u2022\u00a0Maintain excellent intradepartmental communication; maintain good rapport with Practice Management and other departments and employees throughout Steward. \u2022\u00a0Educate practices\/providers on basic coding, documentation, and billing issues related to appropriately charging for, and documenting the services delivered in compliance with applicable rules and regulations. \u2022\u00a0Educate key stakeholders on significant matters related to coverage decisions, coding issues, and new or revised regulations. \u2022\u00a0Based on experience and industry knowledge, make recommendations to streamline processes related to accurate and appropriate revenue capture for services performed, ensuring compliance with all appropriate regulations and guidelines. \u2022\u00a0Complete required continuous training and education, including department specific requirements. \u2022\u00a0Maintains certifications and stays current on industry trend. Qualifications: \u2022\u00a0Bachelor's degree or equivalent experience required. \u2022\u00a05 years of related work experience. \u2022\u00a0Must have CPC or CCS-P, Certification of healthcare compliance (CHC) strongly preferred. \u2022\u00a0Advanced experience utilizing Microsoft Excel: Including Pivot tables. Beginner\/Intermediate experience with Microsoft Access. \u2022\u00a0Experience should include thorough knowledge of health care operations, physician practice reimbursement including RVUs, charging practices, governmental coding requirements including extensive knowledge of CPT \/ HCPCS \/ ICD and modifiers, and healthcare financial systems. \u2022\u00a0Experience in researching, interpreting and applying Medicare, Medicaid, MASSHEALTH, and other third party payer regulations is essential. \u2022\u00a0Superior analytical skills, excellent writing, organizational and interpersonal skills, to communicate information effectively and to work with the vast array of information gathered, its analysis, and delivery to the requesting management team. \u2022\u00a0Demonstrated highly developed project management skills, along with excellent problem solving and analytical skills, and verbal and written communication skills.

Company info

Saint Anne's Hospital
Website : https://www.saintanneshospital.org/home

Company Profile
We recognize that you have a choice about where to go for your health care. Your time is valuable, and it's important for you to have quick and easy access to information that can help you make important decisions for you and your family. Whether you are seeking a physician, updates on new technology, or a support group, you've come to the right place.

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