kedanger1
Contributor
CHILDRENS HEALTHCARE OF ATLANTA
JOB DESCRIPTION
I. SUMMARY
To audit and monitor the coding and billing activities for the physicians employed at Children's Healthcare of Atlanta. Monitors and works toward accurate evaluation and management selection by minimizing denial issues so appropriate reimbursement for the services provided is attained. Works with the Management Team to educate physicians on coding and documentation compliance.
II. MINIMUM QUALIFICATIONS - EDUCATION / EXPERIENCE REQUIREMENTS
1. High School Diploma or equivalent. College coursework or Degree preferred.
2. CCA, CCS, CCS-P, CPC, or CPC-H certification required within 1 year of hire.
3. Five (5) years healthcare experience, including three (3) years relevant experience with physician practice coding, documentation, billing, and/or reimbursement.
4. Demonstrated customer service skills, including problem solving skills, and demonstrated communication skills, both written and verbal, to ensure message is received and understood by the customer.
Current and valid Georgia drivers license.
CPC or CCS-P certification preferred.
III. FUNCTIONAL COMPETENCIES / JOB DUTIES
1. Develops a detailed audit plan for area being reviewed by maintaining a close working relationship with Coding Management and System Leaders to meet established goals and responsibilities of maintaining consistent quality monitoring processes to validate coding and billing accuracy that minimize denials.
2. Conducts the coding and billing compliance audit process within established time frame and in accordance with the standards defined by Children's Healthcare of Atlanta.
3. Prepares a report of findings for each audit and the action plan for implementation of recommendations for correction and/or improvement.
4. Monitors the progress of developed action plans by developing and administering coding education program(s) that ensure providers and staff maintain coding and billing competencies and are current with coding requirements and regulations, ensuring that current coding manuals and super bills are provided for each practice office, and acting as coding and billing compliance resource for the employed physicians at Children's Healthcare of Atlanta.
5. Utilizes available resources and continuing education programs to remain knowledgeable and current with coding and billing compliance regulations. Meets annual requirements to maintain CPC or CCS-P certification.
6. Performs other duties as assigned.
IV. CHILDRENS COMPETENCIES
1. Demonstrates competence as described in the Performance System.
2. Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Immediately reports any mechanical or electrical equipment malfunctions, employee/patient/visitor injuries or accidents, or other safety issues to supervisor or Compliance Office.
3. Provides excellent service routinely in interactions with all customers, i.e. coworkers, patients, visitors, physicians, volunteers, etc.
4. Performs other duties and responsibilities as required.
5. Demonstrates adherence to the Childrens Compliance Program as described in the Standards of Conduct; attends appropriate compliance training; demonstrates an understanding of the Compliance reporting process and Non-Retaliation Policy.
V. PHYSICAL DEMANDS
Hearing/Speaking: Effective communication with patients, staff, and visitors.
Visual Demands: 40% of the workday. Requires close attention to detail by reading medical records, data, coding resources, viewing computer screens, and reading computer-printed reports.
Repetitive Motion: 05% of the workday. (Fingers/wrists, hands/arms).
Standing: 05% of the workday.
Sitting: 30% of the workday.
Walking: 05% of the workday.
Climbing: 0% of the workday.
Pushing/Pulling: 05% of the workday.
Bending/Stooping:05% of the workday.
Lifting: 05% of the workday; Up to 20lbs independently and up to 50lbs with assistance
VI. WORKING CONDITIONS
No potential for exposure to blood and body fluids.
Travel to various satellite offices located within the Atlanta metropolitan area.
The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be an exhaustive list of all job duties performed by the personnel so classified.
JOB DESCRIPTION
I. SUMMARY
To audit and monitor the coding and billing activities for the physicians employed at Children's Healthcare of Atlanta. Monitors and works toward accurate evaluation and management selection by minimizing denial issues so appropriate reimbursement for the services provided is attained. Works with the Management Team to educate physicians on coding and documentation compliance.
II. MINIMUM QUALIFICATIONS - EDUCATION / EXPERIENCE REQUIREMENTS
1. High School Diploma or equivalent. College coursework or Degree preferred.
2. CCA, CCS, CCS-P, CPC, or CPC-H certification required within 1 year of hire.
3. Five (5) years healthcare experience, including three (3) years relevant experience with physician practice coding, documentation, billing, and/or reimbursement.
4. Demonstrated customer service skills, including problem solving skills, and demonstrated communication skills, both written and verbal, to ensure message is received and understood by the customer.
Current and valid Georgia drivers license.
CPC or CCS-P certification preferred.
III. FUNCTIONAL COMPETENCIES / JOB DUTIES
1. Develops a detailed audit plan for area being reviewed by maintaining a close working relationship with Coding Management and System Leaders to meet established goals and responsibilities of maintaining consistent quality monitoring processes to validate coding and billing accuracy that minimize denials.
2. Conducts the coding and billing compliance audit process within established time frame and in accordance with the standards defined by Children's Healthcare of Atlanta.
3. Prepares a report of findings for each audit and the action plan for implementation of recommendations for correction and/or improvement.
4. Monitors the progress of developed action plans by developing and administering coding education program(s) that ensure providers and staff maintain coding and billing competencies and are current with coding requirements and regulations, ensuring that current coding manuals and super bills are provided for each practice office, and acting as coding and billing compliance resource for the employed physicians at Children's Healthcare of Atlanta.
5. Utilizes available resources and continuing education programs to remain knowledgeable and current with coding and billing compliance regulations. Meets annual requirements to maintain CPC or CCS-P certification.
6. Performs other duties as assigned.
IV. CHILDRENS COMPETENCIES
1. Demonstrates competence as described in the Performance System.
2. Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Immediately reports any mechanical or electrical equipment malfunctions, employee/patient/visitor injuries or accidents, or other safety issues to supervisor or Compliance Office.
3. Provides excellent service routinely in interactions with all customers, i.e. coworkers, patients, visitors, physicians, volunteers, etc.
4. Performs other duties and responsibilities as required.
5. Demonstrates adherence to the Childrens Compliance Program as described in the Standards of Conduct; attends appropriate compliance training; demonstrates an understanding of the Compliance reporting process and Non-Retaliation Policy.
V. PHYSICAL DEMANDS
Hearing/Speaking: Effective communication with patients, staff, and visitors.
Visual Demands: 40% of the workday. Requires close attention to detail by reading medical records, data, coding resources, viewing computer screens, and reading computer-printed reports.
Repetitive Motion: 05% of the workday. (Fingers/wrists, hands/arms).
Standing: 05% of the workday.
Sitting: 30% of the workday.
Walking: 05% of the workday.
Climbing: 0% of the workday.
Pushing/Pulling: 05% of the workday.
Bending/Stooping:05% of the workday.
Lifting: 05% of the workday; Up to 20lbs independently and up to 50lbs with assistance
VI. WORKING CONDITIONS
No potential for exposure to blood and body fluids.
Travel to various satellite offices located within the Atlanta metropolitan area.
The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be an exhaustive list of all job duties performed by the personnel so classified.
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