Maine Department Of Education South Portland , ME 04116
Posted 1 week ago
Maintain current knowledge of coding guidelines and applies knowledge to determine if coding and documentation meets regulatory guidelines and audit standards
Perform audits of medical record documentation for coding accuracy based on CPT, HCPCS, ICD-10 guidelines, private payer and CMS guidelines as well as InterMed Policies as appropriate; Escalate identified documentation/coding errors for review by clinical coding educator
Select samples of medical records for internal and external audit and document results, based on Coding Compliance Plan
Adjust coding as necessary, documenting rationale for coding decisions, comparing auditor findings against those generated from the provider, identifying and recording discrepancies, and recording the rationale for changes in coding decisions
Research coding guidelines and documentation requirements
Coordinate communication of coding audit results in collaboration with the clinical coding educator
Develop coding education materials in collaboration with the clinical coding educator
Maintain documentation of audits performed, such as to medical record samples, coding error rationale, accuracy scores and due dates in accordance with the Coding Compliance plan
Monitor for changes and updates to payer and CMS policies related to coding and documentation
Work collaboratively, seeking additional opinion(s) when needed
Other duties as assigned
JOB REQUIREMENTS
Associates Degree, or equivalent experience, required
Certified Professional Coder (CPC) required; Certified Officer of Compliance (COC) or Certified Risk Coder (CRC) preferred
Knowledge of the revenue cycle, medical terminology
Knowledge of billing, coding, insurance practices, and the 'language' associated with each
Excellent interpersonal as well as written and verbal communication skills
Strong Microsoft Office Suite (Including Word, Excel and Powerpoint) and EMR (eClinicalWorks) skills
At least four years of revenue cycle experience required
InterMed is an equal opportunity workplace and prohibits discrimination or harassment of any kind. We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, gender identity and/or expression, sexual orientation, marital status, disability, veteran status, or any other basis protected by applicable federal, state or local law.
Qualifications
Maine Department Of Education