Coding and Compliance Specialist

Company : Columbus Oncology & Hematology

Job Description - Coding and Compliance Specialist

SUMMARY: The Coding and Compliance Specialist is primarily responsible for coding and auditing related functions ensuring coding compliance, data integrity, and correct claims.

ESSENTIAL DUTIES AND RESPONSIBILITIES: The essential duties and responsibilities of this job include the following. These are the duties that define this job and are required to be performed by the incumbent. Other essential duties may be assigned.

Perform daily review of coding and clinical documentation for pending charges allowing for correct data entry and clean claims
- Confirm appropriate clinical documentation is present in patient medical record
- Verify appropriate CPT and HCPCS codes are assigned for services provided
  - Add or modify codes as necessary
  - Apply payer-specific data requirements
  - Assign appropriate modifiers to correctly reflect the service(s) provided
  - Indicate NDC code as needed to accurately support medications administered
Track and monitor outstanding documentation and/or missing charge tickets
- Follow-up with clinical manager and physicians as needed
Maintain a current and detailed knowledge of regulatory and compliance related requirements impacting physician practices
- Stay up to date with current events related to professional billing and coding utilizing available resources; especially related to oncology
- Review payer newsletters and policies
  - Collaborate and communicate with Lead Coding and Compliance Specialist, management, and physicians as necessary
- Assist Lead Coding and Compliance Specialist with education across the organization as needed to ensure compliance is understood, achieved, and maintained
Achieve and maintain an understanding of government and payer initiatives impacting reimbursement (i.e. MACRA, MIPS)
Collaborate with Lead Coding and Compliance Specialist, Lead Billing Specialist, and billing team to review, research, and resolve clinical and coding related claim denials
- Assist with appeals process as necessary to ensure payment Coding and Compliance Specialist
- Communicate with physicians and/or clinical manager to obtain additional clinical knowledge
Develop and maintain a working knowledge of practice management system and electronic health record

QUALIFICATIONS: In order to qualify for this job the incumbent must possess the following qualifications or be able to secure them within 90 days.

EDUCATION AND/OR EXPERIENCE
- This job requires this education and/or experience background. Other desirable or preferred education and/or experience may be listed.
  - 1-3 years of current experience in a physician practice business office performing medical coding with documentation review
  - Understanding of professional coding and compliance and the associated variables that can impact claims and reimbursement
    - Working knowledge of electronic claim edits and claim submission
  - Strong knowledge of CPT and ICD-10 coding
  - Strong medical terminology
  - Moderate level of computer skills including EMR (electronic medical record), , Microsoft Office applications (Outlook, Word, Excel), and use of the internet
  - High school diploma or GED
  - Oncology experience preferred

Columbus Oncology Associates is an Equal Opportunity Employer and proudly a Drug-Free Workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.

Original job Coding and Compliance Specialist posted on GrabJobs ©. To flag any issues with this job please use the Report Job button on GrabJobs.

Share Job

Get your Resume Reviewed for Free

Similar Coding and Compliance Specialist Jobs in the US

Get your Resume Reviewed for Free

Email address

Why are you reporting this job?

I think it’s a discriminatory or offensive

I think it’s fraudulent or a scam

I think it’s trying to sell something unrelated to the job / it’s asking for money

I think it contains incorrect or broken information

Other

All Job Ads are subject to GrabJobs’s Terms of Service. We allow users to flag postings that may be in violation of those terms. Job Ads may also be flagged by GrabJobs moderation team. However, no moderation system is perfect, and flagging a posting does not ensure that it will be removed.

Setup your job alert:

Frequency

By activating job alerts, I agree to GrabJobs Terms & Privacy Policy. I can unsubscribe to job alerts anytime. Skip

Coding and Compliance Specialist

Job Description - Coding and Compliance Specialist

Similar Coding and Compliance Specialist Jobs in the US

Mobile Apps