Medical Coder Compliance Specialist

University of Michigan; Ann Arbor (MI); Hybrid; USD 80,000 - 110,000; Full time

Benefits offered by this job

Excellent medical, dental and vision 1

2:1 Match on retirement savings

Job summary

University of Michigan's Michigan Medicine is seeking an experienced Coding Quality Auditor to perform outpatient coding audits for CPT/ICD-10-CM, ensuring accuracy and CMS guideline compliance. You will develop and deliver educational programs, and act as a subject matter expert for the outpatient coding department.

The role requires coordinating training, providing feedback to improve code accuracy, and contributing to departmental policies and process improvements within Revenue Cycle

Qualifications

• Associate's degree in healthcare related field or equivalent.
• CPC/COC/RHIT/RHIA/CCS/CCS-P credential required.
• Three years' experience coding or auditing CPT, ICD-10-CM, and modifier assignment.
• Extensive knowledge of federal and state regulations and policies pertaining to documentation and coding.

Responsibilities

• Perform pre and/or post bill secondary chart review to validate modifier selection, E/M, procedural, and diagnosis coding.
• Provide workflow and coding training to new hires.
• Offer feedback to coding staff to improve code selections per guidelines.
• Review and prepare education sessions on coding guidelines for outpatient coders.
• Develop educational programs related to the Coding Compliance Program and documentation quality.
• Respond to inquiries regarding Revenue Cycle Mid-Service processes and coding standards.
• Participate in process improvement initiatives through technology.
• Assist with coding during unplanned emergencies.

Skills

CPT/ICD-10-CM coding

Auditing and quality review

Education/training

Communication skills

Attention to detail

Problem solving

Education

Associate's degree in healthcare related field

Certified Coding Specialist (CCS/CCS-P) or CPC/COC/RHIT/RHIA

Job description

Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally.Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Job Summary

Perform coding quality audits on outpatient records to assure appropriateness, accuracy, and compliance for CPT/HCPCs, ICD-10-CM code assignments, and modifier assignment in accordance with Center of Medicare and Medicaid Service (CMS) Guidelines, AMA and AHA Official ICD-10-CM Coding Guidelines. Provide ongoing feedback to managers and coders. Develop and implement educational programs regarding elements of the coding compliance program and act as a subject matter expert for the outpatient coding department.

Responsibilities*

Characteristics, Duties, & Responsibilities:

OPERATIONS

• Perform pre and/or post bill secondary chart review to validate modifier selection, E&M, procedural, and diagnosis coding in accordance with established coding guidelines
• Provide workflow and coding training to new hires
• Continuously provide feedback to coding staff to improve code selections that accurately describe the procedures and services performed by physicians in accordance to NCCI, AMA/CPT & ICD 10- guidelines
• Review and Dissect coding clinics, yearly AMA guidelines, ICD-10-CM and NCCI to prepare education sessions to outpatient coders.
• Develop and coordinate educational and training programs regarding elements of the Coding Compliance Program, such as appropriate documentation, accurate coding, and coding trends found during chart reviews.
• Respond to complex internal and external customer inquiries in relation to Mid-Service processes, documentation, and coding compliance standards.
• Participate in process improvement initiatives by use of technology
• Revise and/or write Policies & Procedures related to Revenue Cycle Mid-Service
• Assist with coding in the event of an unplanned emergency
• Demonstrate initiative by the continuous expansion of knowledge and skills
• Participate in department/unit activities including, but not limited to, staff meetings and in-services
• Perform other duties as assigned to maintain the efficiency of the department
• Protect the confidentiality of primary and secondary health records and the information therein as mandated by law, professional standards, and Health System policies
• Demonstrates excellent customer service skills in working with Revenue Cycle staff, clinicians, and other UHMS staff. Model, support and reinforce a culture of service excellence

SKILLSET

• Extensive CPT/ ICD-10-CM coding knowledge with a strong understanding of the AMA, AHA and NCCI Official Coding Guidelines and how to apply them.
• Ability to leverage technology for process improvement.
• Analyze guidelines to provide in-depth education to staff.
• Write appropriate queries to the clinical care team in accordance with the AHIMA Query Policy.
• Attention to detail with thoroughness and accuracy when accomplishing a task.
• Participate as an active member of Lean Thinking in daily work initiatives
• Excellent verbal and written communication skills, analytical thinking, and problem-solving skills with attention to detail are required.
• Proficiency in organizational skills and planning with an ability to juggle multiple priorities in a fast-changing environment
• Experience in developing and providing education to coders and physicians
• Ability to work independently, be self-motivated, and the ability to adapt to the changing healthcare environment.

Required Qualifications*

• Associate's degree in healthcare related field or an equivalent combination of education and/or experience.
• Certified Professional Coder (CPC), or Certified Outpatient Coder (COC), or Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS/CCS-P) credential.
• Three years' experience coding or auditing CPT, ICD-10-CM, and modifier assignment.
• Extensive knowledge of federal and state regulations and policies pertaining to documentation and coding.

Why Join Michigan Medicine?

Michigan Medicine is one of the largest health care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School in 1850. Michigan Medicine is comprised of over 30,000employees and our vision is to attract, inspire, and develop outstanding people in medicine, sciences, and healthcare to become one of the world?s most distinguished academic health systems. In some way, great or small, every person here helps to advance this world-class institution. Work at Michigan Medicine and become a victor for the greater good.

What Benefits can you Look Forward to?

• Excellent medical, dental and vision coverage effective on your very first day
• 2:1 Match on retirement savings

Modes of Work

Mobile/Remote - the work requirements allow for the majority or all the work to be completed offsite. On occasion, the employee may be required and must be available to work onsite if necessitated by unit leadership or their designee and/or the job requirements.

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes .

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

Application Deadline

Job openings are posted for a minimum of seven calendar days. The review and selection process maybegin as early as the eighth day after posting.Thisopening may be removed from posting boards and filled anytime after the minimum posting period has ended.

U-M EEO Statement

The University of Michigan is an Equal Opportunity Employer. We are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants, including protected veterans and individuals with disabilities.