CERTIFIED PROFESSIONAL CODER (ON-SITE)

DaMar Staffing; Kankakee (IL); On-site; USD 63,835,000 - 106,392,000; Full time

Job summary

Riverside Medical Group is seeking a Professional Coding Compliance Specialist to audit provider documentation and coding for accuracy, completeness, and regulatory compliance. You will review ICD-10-CM and CPT/HCPCS, discuss findings with providers, and help develop provider education materials and monthly newsletters.

You will collaborate with the coding compliance team to maintain current guidelines, orient new staff, and support education programs to improve coding quality and compliance

Qualifications

• Minimum three years current ICD-10-CM and CPT/HCPCS (including E/M assignment) coding experience in a multi-specialty medical practice or comparable coding experience.
• High school graduate or equivalent.
• AAPC/CPC required.
• AAPC/CPMA strongly recommended at hire; required within two years of hire.
• AAPC/CRC strongly recommended.
• Associate degree in health-related field preferred.

Responsibilities

• Completes timely audits of assigned providers and coders for accurate, complete, and compliant ICD-10-CM and CPT/HCPCS code assignment, ensuring that documentation supports the diagnoses reported, E/M level selected, and CPT/HCPCS codes submitted for services rendered during the episodes of care reviewed.
• Reviews audit findings with assigned providers and coders, providing real-time education on opportunities identified and offering objective supporting documentation to support findings and use as reference.
• Documents audit results in designated Excel log as soon as review is completed.
• Immediately reports adverse audit trends, potential areas of risk, and compliance concerns to management.
• Assists coding compliance lead in creating and publishing monthly provider newsletter.
• Collaborates with coding compliance team and provider-focused coding manager to develop and maintain current coding guidelines for Riverside Medical Group as a whole and its specialists to ensure compliance and consistency across practices and their assigned coding teams.
• Participates in developing and presenting provider and coder education programs as requested.
• Assists coding compliance lead in maintaining orientation materials for new providers, residents, and fellows that reflect current coding and documentation rules and requirements
• Assists provider-focused coding manager and coding compliance lead in orienting and educating new team members as requested
• Serves as coding compliance resource to Riverside Medical Group and Riverside Medical Center as requested
• Assists in provider-focused coding and charge entry as needed to meet fiscal deadlines and backfill staff vacancies

Skills

ICD-10-CM

CPT/HCPCS

E/M assignment

Education

High school graduate

AAPC CPC

AAPC CPMA

AAPC CRC

Associate degree preferred

Job description

Overview

The Professional Coding Compliance Specialist provides revenue cycle support to Riverside Medical Group and its coding team by regularly auditing provider documentation and corresponding coding to ensure correct, complete and compliant practices that fully support diagnoses reported and charges submitted for services rendered, meet regulatory and payor-specific requirements, and accurately describe the patient encounter; providing feedback and education to providers and coders based on audit results, regulatory changes, and industry trends; assisting with orientation of new providers, residents/fellows, and new members of the coding team.

Essential Duties

Completes timely audits of assigned providers and coders for accurate, complete, and compliant ICD-10-CM and CPT/HCPCS code assignment, ensuring that documentation supports the diagnoses reported, E/M level selected, and CPT/HCPCS codes submitted for services rendered during the episodes of care reviewedReviews audit findings with assigned providers and coders, providing real-time education on opportunities identified and offering objective supporting documentation (e.g., current coding conventions, regulatory/payor-specific requirements, risk-adjustment guidelines, organization-specific policies) to support findings and use as referenceDocuments audit results in designated Excel log as soon as review is completedImmediately reports adverse audit trends, potential areas of risk, and compliance concerns to managementAssists coding compliance lead in creating and publishing monthly provider newsletterCollaborates with coding compliance team and provider-focused coding manager to develop and maintain current coding guidelines for Riverside Medical Group as a whole and its specialists to ensure compliance and consistency across practices and their assigned coding teamsParticipates in developing and presenting provider and coder education programs as requestedAssists coding compliance lead in maintaining orientation materials for new providers, residents, and fellows that reflect current coding and documentation rules and requirementsAssists provider-focused coding manager and coding compliance lead in orienting and educating new team members as requestedServes as coding compliance resource to Riverside Medical Group and Riverside Medical Center as requestedAssists in provider-focused coding and charge entry as needed to meet fiscal deadlines and backfill staff vacancies

Required Experience

Minimum three years current ICD-10-CM and CPT/HCPCS (including E/M assignment) coding experience in a multi-specialty medical practice or comparable coding experience required

Required Licensure/Education

High school graduate or equivalent required.AAPC/CPC (Certified Professional Coder) requiredAAPC/CPMA (Certified Professional Medical Auditor) strongly recommended at hire; required within two years of hireAAPC/CRC (Certified Risk-Adjustment Coder) strongly recommended

Preferred Education

Associate degree in health-related field preferred

Formal education in ICD-10-CM and CPT/HCPCS coding principles and assignment maintained by relevant continuing education

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our Commitment to You:

Riverside Healthcare offers a comprehensive suite of Total Rewards: benefits and nationally rated employee well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more so your journey at and away from work is remarkable. Our Total Rewards package includes:Compensation:Base compensation within the positions pay range based on factors such as qualifications, skills, relevant experience, and/or traininPremium pay such as shift differential, on-callOpportunity for annual increases based on performanceBenefits - .5 to 1.0 FTE:Paid Time Off programsHealth and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term DisabilityHealth Savings and Flexible Spending Accounts for eligible health care and dependent care expensesDefined contribution retirement plans with employer match and other financial wellness programsEducational Assistance ProgramBenefits - .001 to .49 FTE:Paid Leave Hours accrued as you workEmployee Health RequirementsExposure/Sensory Requirements:Exposure to:Chemicals: NAVideo Display Terminals: AverageBlood and Body Fluids: NoneTB or Airborne Pathogens: NoneSensory requirements (speech, vision, smell, hearing, touch):Speech: Needed for presentations/training, telephone communication, facilitate meetings.Vision: Needed to read computer screens and printouts, memos, communications, documentation, and literature.Smell: Electrical/fire safety.Hearing: Needed to telephone communications, meetings, and equipment operating characteristics.Touch: Needed to write, do computer entry, filing.Activity/Lifting Requirements:Percentage of time during the normal workday the employee is required to:Sit: 55%Twist: 0%Stand: 20%Crawl: 0%Walk: 20%Kneel: 0%Lift: 0%Drive: 0%Squat: 0%Climb: 0%Bend: 5%Reach above shoulders: 0%The weight required to be lifted each normal workday according to the continuum described below:Up to 10 lbs: FrequentlyUp to 20 lbs: OccasionallyUp to 35 lbs: OccasionallyUp to 60 lbs: OccasionallyUp to 75 lbs: Not RequiredUp to 100 lbs: Not RequiredOver 100 lbs: Not RequiredDescribe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):Putting away supplies.Lift above the head occasionally to place boxes on high storage shelves.Carry boxes up and down the stairs - distances up to 100 feetMaximum consecutive time (minutes) during the normal workday for each activity:Sit: 30Twist: .5Stand: 30Crawl: 0Walk: 2Kneel: 0Lift: 5Drive: 30Squat: 1Climb: .5Bend: .5Reach above shoulders: .5Repetitive use of hands (Frequency indicated):Simple grasp up to 15 lbs.Normal weight: continuousPushing &pulling Normal weight: 50-200#Fine Manipulation: Computer Keyboard and mouse.Repetitive use of foot or feet in operating machine control: Not RequiredEnvironmental Factors & Special Hazards:Environmental Factors (Time Spent):Inside hours: 8.0Outside hours : 0Temperature: Normal RangeLighting: AverageNoise levels: AverageHumidity: NormalAtmosphere:Special Hazards:Protective Clothing Required: Gloves when handling blood and body fluids.Pay RangeUSD $28.83 - USD $37.13 /Hr