Performs E&M and CPT coding audits as well as other projects related to physician coding compliance.
Position: MANAGER, PHYSICIAN CODING COMPLIANCEJob Summary: Performs E&M and CPT coding audits as well as other projects related to physician coding compliance. Completes audit assignments and other projects in fulfillment of compliance department work plans. Demonstrates a thorough understanding of complex coding, reimbursement, and health information management processes, and auditing principles as they relate to physician practice settings. Communicates with engagement team and client management teams regarding complex coding and auditing issues and current coding regulations. Keeps informed regarding current coding regulations, professional standards and company/department policies and procedures and effectively applies this knowledge. General Responsibilities:1. Implements audit engagements including scheduling and undertaking audit fieldwork with minimal supervision.2. Analyzes data, identifies issues, reaches conclusions, and proposes strategies for resolution of complex coding issues.3. Prepares working papers, reports and memoranda regarding audit results and coding compliance matters. 4. Develops and maintains spreadsheet data related to coding and documentation compliance and trending.5.Reports to department leadership regarding completion of compliance work plan obligations.6. Communicates effectively with operations personnel and company leadership regarding coding and documentation compliance matters.7. Serves as a trusted business advisor by providing facility personnel with professional advice and best practice information regarding coding compliance.8. Mentors staff and other department personnel at the request of department leadership.9. Provides input and guidance in the development and review of detailed audit programs and reports to improve audit effectiveness and efficiency.10. Assists in developing and executing department educational plans related to coding matters, working in conjunction with the Director of Compliance Education.11. Monitors and reports to company leadership including the corporate compliance committee matters related to coding compliance.12. Develops procedures manual for all major processes under area of responsibility. 13. Undertakes continuous education to maintain technical coding, HIM, auditing and management skills consistent with the company and departments professional development requirements and individual credentials.14. Works with department leadership to improve compliance department processes, and to enhance overall compliance posture of the overall organization.15. Maintains confidentiality in accordance with legal obligations and the company Code of Conduct.16. Demonstrates outstanding work ethic, and work cooperatively with all team members and clients with a can-do spirit and team attitude.17. Performs other department duties as assigned. 18. Ability to travel up to 50% of the time. Minimum Qualifications (Experience, Education and Special Certifications)Associates Degree in Health Information TechnologyRHITOne of the following certifications:oCCS-PoCPCoCPC-HTwo years of physician coding experience or equivalent.