Responsible for audits which are internal record reviews for compliance with coding regulations and guidelines in order to provide rebuttals to CMS or other payer denials and to assist and improve on physician correct coding/documentation education. Provides assistance with the creation of EMR templates in order to to improve capture of correct documentation to support E&M (Evaluation and Management Coding) levels. Responds to government and other payers records requests and audits.
Work requires the level of knowledge normally acquired through the completion of two to three years of occupationally specific education beyond high school OR an Associates degree in Medical Record Technology or closely related field and two to three years of previous work related experience. Certified coder with auditing experience required for ensuring accuracy of coding and documentation on hard copy charts and electronic forms and using ICD/CPT. Monitors regulatory changes on coding/auditing guidelines. Works closely with physicians and billing staff on coding, documentation, and improvements. Ability to use independent judgment to manage and impart confidential information. Must be knowledgeable of legal, regulatory and policy compliance issues related to medical coding and billing procedures and documentation. Ability to communicate clearly to professional practitioners and or the general public.
Job details are sourced from the employer's original posting.
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St. Joseph's Health is a comprehensive health system providing a wide range of medical services and patient care.