Coding Integrity Specialist - Central Billing Office *Onsite, Boynton Beach, FL

Company: Winthrop University Hospital
Location: Boynton Beach
Posted on: May 24, 2023

Job Description:

Position Summary:Reports to the Coding Quality Manager as a part of the revenue cycle team.Job Responsibilities:Perform other duties as needed.Objectively review and Audit clinical documentation, CPT-4, HCPCS, modifiers and ICD-10 coding to ensure accurate reimbursement and compliance with CMS and third party payer laws and regulations.Develops complete reports reflecting audit findings including negative and positive trends. Reports findings to leadership and follows through as directed.Effectively and professionally communicate complex information in both oral and written format in a way that is understandable to the audience.Provide professional coding, billing, and compliance guidance/education to offshore coding dependently analyze and weigh the risks verses benefits in decisions and recommendations related to provider billing and bill audit issues.Promptly report any and all potential compliance issues to leadership and the Director of Compliance if necessary.Research and update new and/or revised coding and compliance standards utilizing multiple government resources including: CMS, AMA, OIG, etc.Assist in the development of coding policies and procedures.Reviews, monitors, and facilitates implementation of billing and coding changes affecting charge capture processes in accordance with payer requirements.Apply critical thinking, negotiation and conflict resolution skills.Maintain collaborative relationships with internal and external teams to ensure integration and alignment of department priorities.Effectively use various computer applications to conduct research, create reports and presentation material.Assist with special projects on as-needed basis.Prepares and presents coding materials at revenue cycle meetings.Minimum Qualifications:Bachelor's degree and 3-5 years of auditing and revenue cycle management experience in a healthcare environment.Extensive knowledge of coding principles and guidelines.Knowledge of RAC process including targeted coding areas.Extensive knowledge of reimbursement systems, as well as federal, state and payer-specific regulations and policies pertaining to documentation, coding and billing.Knowledge of Electronic Medical Records.Proficient in Microsoft Office applications: Word, Excel and Powerpoint and others as requiredStrong interpersonal communication and presentation skills, effectively presenting information to management, faculty practice groups and individuals.Excellent organizational and project management skills.Strong time management, attention to detail, and follow through.Well-developed research skills.Strong knowledge of revenue cycle process, revenue integrity and its impact throughout the revenue cycle.Required Licensure/Certification skills: Certified Coding Specialist Certification (CCS) or Certified Coding Specialist- Physician-based (CCS-P) or Certified Professional Coder (CPC), Certified Outpatient Coding (COC).

Keywords: Winthrop University Hospital, Boynton Beach , Coding Integrity Specialist - Central Billing Office *Onsite, Boynton Beach, FL, Accounting, Auditing , Boynton Beach, Florida