Under the direction of the Physician Coding Manager, and following a pre-determined or assigned audit schedule, provide an evidence-based review of select primary and specialty care E&M and procedural charges to ensure correct coding, legal compliance and complete charge capture. This person may also be asked to assist with other special projects related to charge capture and rebilling projects. Participation in the department's performance improvement and continuous quality improvement activities is required.
DUTIES AND RESPONSIBILITIES:
Using CPT and ICD-9/ICD.10, HCPCs II, provider documentation and other approved resources, evaluate the proper assignment of procedure, modifier and diagnosis codes to professional services in order to validate accuracy and compliance.
Collate, transfer and analyze all auditing results to capture and illustrate risk issues, revenue leakage and educational opportunities.
Provide physician feedback, initial and ongoing education and training, and technical support in regards to proper clinical documentation guidelines, service selection, charge capture and timely submission, healthcare data accuracy and coding principles.
Assist with developing and implementing recommendations for changes in policies and procedures relevant to correct and complaint coding.
Serve as a resource for physicians, billing and coding staff and administrative staff relative to technical guidance on professional coding issues.
Stay current with all coding changes and updates through regular research and verification.
Responsible for identifying issues and implementing process improvements for charge accuracy.
Treats others with respect; maintains confidentiality
Demonstrates a good working relationship within the department and with other departments
Demonstrates the ability to be flexible and organized in stressful situations.
Operates equipment safely and correctly.
Perform other projects as assigned by Manager of Physician Coding.
Demonstrates the ability to deal with pressure to meet deadlines, to be accurate, and to handle constantly changing situations.
Demonstrates the ability to deal with a variety of people, deal with stressful situations, and handle conflict.
Adheres to dress code.
Completes annual educational requirements.
Maintains regulatory requirements.
Wears identification while on duty.
Maintains confidentiality at all times.
Attends department staff meetings as required within the department.
Reports to work on time and as scheduled; completes work in designated time.
Represents the organization in a positive and professional manner.
Actively participates in performance improvement and continuous quality improvement (CQI) activities.
Coordinates efforts in meeting regulatory compliance, federal, state and local regulations and standards
Communicates and complies with the Benefis Health System Mission, Vision and Values as well as the focus statement of the department.
Complies with Benefis Health System Organization Policies and Procedures.
Complies with Health and Safety Standards and Guidelines.
Three to five years E&M coding/auditing experience in primary and specialty coding.
Minimum three years of providing physician education.
As a not-for-profit community health system, Benefis is driven to provide the highest level of care. We serve nearly 230,000 residents across a 15-county region that is bigger than Connecticut, Massachusetts, New Hampshire and Vermont combined. Benefis is the largest non-governmental employer in the Great Falls area, with more than 3,000 employees.Benefis has 530 licensed beds (that includes 146 beds in long-term care, 71 in assisted living and 20 beds at Peace Hospice of Montana) and partners with over 250 area physicians.Our hospital has been recognized for its exceptional work in quality care by providing a wide range of programs and services to help you live the best life possible. We’re here to help you “Live well.”Benefis Health System came about when two Christian-based hospitals became one. Our founders believed in providing good care to all in need, and trusted that this would be accomplished. The Benefis name was derived using Latin root words: "Bene-" meaning good, and "fis-" for faith and trust. It’s these same root words that make up such terms as ‘beneficial’ and ‘confidence’.Benefis has been a trusted provider of care for more than 125 years. And our name speaks to o...ur commitment: good care one can put faith in.Benefis is consistently ranked among America’s top hospitals by the nation’s leading healthcare ratings organizations for a range of services, including cancer care, joint replacement, stroke treatment, wound care and home health.To learn more about our services, continue looking through our website at WWW.BENEFIS.ORG or call 406.455.5000.