Coding & Compliance Specialist

F. F. Thompson Health; Town of Canandaigua (NY); On-site; USD 28,000 - 34,000; Full time

Job summary

Thompson Health in Canandaigua, NY seeks a Billing/Compliance Specialist with CPC-A certification to oversee coding, billing, and regulatory compliance. You will audit medical records, develop reports, and interact with patients, payers, and staff throughout the health system. Strong EMR skills and knowledge of RBRVS are essential.

3–5 years healthcare billing experience is preferred; CPC-CPC-H is a plus. Excellent communication and MS Office proficiency are required.

Qualifications

• 3–5 years of healthcare experience preferred.
• Billing experience preferred.
• Excellent public/patient relations and communication skills.
• Skills in using computers including Excel and Word.
• Extensive knowledge of RBRVS and federal, state, and other payer regulations pertaining to documentation, coding (E&M, modifiers, critical care) and billing.

Responsibilities

• Coordinates and conducts periodic medical record audits for providers to assess compliance with coding, billing, documentation, and payer regulations.
• Develops reports as directed and reports findings to management and providers.
• Communicates with patients, payer representatives and associates throughout the Health System.
• Proactively resolves problems, recommending and implementing process changes.
• Demonstrates competency in hospital third party insurance billing including federal and state regulations.

Skills

Customer service

Communication

Team building

Problem solving

EMR experience

Microsoft Office

Medical terminology

Analytical thinking

Education

CPC-A

CPC or CPC-H

Tools

Electronic Medical Records (EMR)

Excel

Word

Outlook

PowerPoint

Job description

• Demonstrates skills in customer service, communication, team building and problem solving.
• Demonstrates competency in all areas of hospital third party insurance billing including federal and state regulations.
• Demonstrates skill in proactively resolving problems, recommending, and implementing process changes.
• Demonstrates skill in communicating with patients, payer representatives and associates throughout the Health System.
• Coordinates and conducts periodic medical record audits for providers to assess compliance with coding (over/under coding, trends), billing, documentation, and payer regulations. Develops reports as directed. Reports findings to management and providers.
• Electronic Medical Record experience preferred
• Highly organized and detail oriented

Qualifications:

• CPC-A required, CPC or CPC-H preferred
• Excellent communication skills and ability to form collaborative partnerships across all service settings.
• Proficient in the use of Electronic Medical Records (EMR); ability to create reports on own and interface with EMR vendor to develop reports where none currently exist
• Extensive knowledge RBRVS and federal, state, and other payer regulations pertaining to documentation, coding (E&M, modifiers, critical care) and billing.
• Ability to analyze coding and actively question and guide providers and/or Billing staff as appropriate.
• Strong medical terminology background
• Competent in Microsoft Office products (Word, Excel, Outlook, PowerPoint). Self-directed, self-starter and able to implement new program
• Accepts responsibility and follows through on projects and activities.
• Ability to assimilate new information and technologies into daily work.

Education:

• CPC-A required
• CPC or CPC-H preferred

Experience:

• 3-5 years of healthcare experience, preferred
• Billing Experience preferred
• Excellent public/patient relations and communication skills.
• Skills in using computers including Excel and Word required.

Pay Range: $20.00 - $25.00/hour

Starting Pay:Based on Experience

Thompson Health is an EOE encouraging individuals with disabilities, and veterans to apply.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
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