Coding & Compliance Specialist

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

Job summary

Thompson Health in Canandaigua, NY is seeking a Billing Specialist who excels in customer service and regulatory knowledge. You will handle third-party insurance billing, collaborate with patients, payer representatives and care teams, and ensure compliance with federal and state rules.

Responsibilities include auditing medical records for coding accuracy (E/M, modifiers, critical care), generating reports with the EMR and external vendors, and using Excel and Word to support documentation.

Qualifications

• CPC-A required; CPC or CPC-H preferred
• Associates degree preferred
• 3-5 years healthcare experience preferred
• Billing experience preferred
• Excellent public/patient relations and communication skills
• Skills in using Excel and Word required

Responsibilities

• Coordinate and conduct periodic medical record audits for providers to assess coding and billing compliance.
• Develop reports as directed; report findings to management and providers.
• Communicate with patients, payer representatives, and associates throughout the Health System.
• Assist with third party insurance billing and regulatory compliance (federal and state).
• Proactively resolve problems and implement process changes.

Skills

Customer service

Communication

Team building

Problem solving

Patient communication

Reporting

EMR navigation

Detail oriented

Organization

Education

CPC-A

CPC/CPC-H

Associates degree

Tools

EMR

Excel

Word

Outlook

PowerPoint

Job description

**Schedule:** **Monday - Friday 8am -4:30pm**

Required Job Specific Competencies

• 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
• Associates degree, 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._**