GENERAL PURPOSE:
The Coding Research and Training assistant is responsible for providing medical coding training and support for providers and staff based on needs identified by the Corporate Compliance Officer/Health Information Manager.
MAIN RESPONSIBILITIES & DUTIES:
Works with Revenue Cycle, Operations and Clinical departments to provide provider and staff trainings including but not limited to the following areas:
ICD-10 application and guidelines
Evaluation and Management selection
Centricity Practice Solution training specific to ICD 10-and procedural coding
Auditing of provider diagnosis, procedural coding and documentation.
Acts as a resource for questions related to HCPCS, CPT and ICD 10-coding.
Evaluates the record for documentation consistency and adequacy during provider coding audits. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established reimbursement and special screening criteria.
Researches codes and guidelines as it pertains to various providers, Informatics, billing and other departments as requested, to give accurate information for the purposes of billing, reporting and auditing.
Assist in auditing, reviewing and reporting to appropriate parties, any findings on various audits done within the oversight of the Compliance program.
Assists with training for all departments involving ICD-10-CM and CPT CM including, but not limited to Evaluation and Management section, Centricity Practice Solution.
Collects and records data accurately on training received by staff.
Trains in various clinical areas (Suboxone, HIV, 340B drugs etc.) to be audited to fully understand the policies and procedures for each area in order to assess, audit and report findings to the Compliance officer.
Maintains audit records for outside auditing purposes as well as further internal auditing purposes.
Prepares for audits by researching materials, policies, procedures and formulating a plan of action. Setting up spreadsheets for data and recording as required.
Communicate audit progress and findings by preparing reports and providing information in meetings when requested.
Assists the Compliance/Coding/HIM lead in reporting, educating, creating and implementing any policy and procedure necessary to ensure that all departments follow regulations according to the Compliance program.
Assist the Compliance Officer with onsite audits as needed.
Enhances compliance department and the organizations reputation by accepting responsibility for accomplishing new and different coding and compliance related requests; exploring opportunities for additional audits/monitoring to ensure the most robust compliance program possible.
Also assists with the coding and HIM department with patient complaints, records requests, incident reports, correcting claims as requested by the Coders, and other duties as assigned.
Travel as needed
Maintains open communication with supervisor and all staff.
Maintains confidentiality of all patients/personnel records.
QUALITIES & CHARACTERISTICS
PROFESSIONAL KNOWLEDGE, SKILLS & ABILITIES
COMMUNICATION SKILLS:
WORKING CONDITIONS & PHYSICAL REQUIREMENTS
Works well with patients, co-workers and vendors in a generally comfortable environment office. Employee must possess the following physical requirements:
GENERAL PURPOSE:
The Coding Research and Training assistant is responsible for providing medical coding training and support for providers and staff based on needs identified by the Corporate Compliance Officer/Health Information Manager.
MAIN RESPONSIBILITIES & DUTIES:
Works with Revenue Cycle, Operations and Clinical departments to provide provider and staff trainings including but not limited to the following areas:
ICD-10 application and guidelines
Evaluation and Management selection
Centricity Practice Solution training specific to ICD 10-and procedural coding
Auditing of provider diagnosis, procedural coding and documentation.
Acts as a resource for questions related to HCPCS, CPT and ICD 10-coding.
Evaluates the record for documentation consistency and adequacy during provider coding audits. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established reimbursement and special screening criteria.
Researches codes and guidelines as it pertains to various providers, Informatics, billing and other departments as requested, to give accurate information for the purposes of billing, reporting and auditing.
Assist in auditing, reviewing and reporting to appropriate parties, any findings on various audits done within the oversight of the Compliance program.
Assists with training for all departments involving ICD-10-CM and CPT CM including, but not limited to Evaluation and Management section, Centricity Practice Solution.
Collects and records data accurately on training received by staff.
Trains in various clinical areas (Suboxone, HIV, 340B drugs etc.) to be audited to fully understand the policies and procedures for each area in order to assess, audit and report findings to the Compliance officer.
Maintains audit records for outside auditing purposes as well as further internal auditing purposes.
Prepares for audits by researching materials, policies, procedures and formulating a plan of action. Setting up spreadsheets for data and recording as required.
Communicate audit progress and findings by preparing reports and providing information in meetings when requested.
Assists the Compliance/Coding/HIM lead in reporting, educating, creating and implementing any policy and procedure necessary to ensure that all departments follow regulations according to the Compliance program.
Assist the Compliance Officer with onsite audits as needed.
Enhances compliance department and the organizations reputation by accepting responsibility for accomplishing new and different coding and compliance related requests; exploring opportunities for additional audits/monitoring to ensure the most robust compliance program possible.
Also assists with the coding and HIM department with patient complaints, records requests, incident reports, correcting claims as requested by the Coders, and other duties as assigned.
Travel as needed
Maintains open communication with supervisor and all staff.
Maintains confidentiality of all patients/personnel records.
QUALITIES & CHARACTERISTICS
PROFESSIONAL KNOWLEDGE, SKILLS & ABILITIES
COMMUNICATION SKILLS:
WORKING CONDITIONS & PHYSICAL REQUIREMENTS
Works well with patients, co-workers and vendors in a generally comfortable environment office. Employee must possess the following physical requirements: