Compliance Educator - Staff Icons
Lakeland, FL 33805
About the Job
Responsibilities :
Required Education and Experience : High School diploma or equivalent. A minimum of 2-3 years in healthcare reimbursement & or coding experience. Knowledge in medical terminology and anatomy. Knowledge of insurance reimbursement, principles, and practice. Proficiency with Microsoft Office. : Certification required: American Academy of Professional Coders (AAPC) – CPC or equivalent organization, American Health Information Management Association, AHIMA –CCS) for a minimum of 2 years. CRC (Certified Risk Coder) certification obtained within 6 months of date of employment. This position is not remote.
Preferred Education and Experience : Knowledge of Client-IDX, Epic,& Cerner for retrospective or concurrent documentation reviews.
- Demonstrate a contribution to the department's operation (Practice Assessments, retrospective &/or concurrent documentation reviews) and goals/targets for the year. Maintain monthly log of activity. Prioritize workload and maintain control over interruptions.
- Develops educational materials to conduct classroom and/or Individual training/education to all providers and staff on coding, documentation, and CMS/Federal guidelines.
- Researches, analyzes, and responds to inquiries regarding inappropriate coding, denials, and billable services in accordance with all CMS/Federal and state guidelines.
- Reviews Hospital and Clinic notes. Conducts coding and documentation reviews: review documentation and coding for all services (including but not limited to; E & M level of service, Surgical procedures, modifier usage, diagnosis code supporting medical necessity, labs and radiologic examinations).
- Review all reimbursement tools for coding/policy additions, revisions and deletions. Items must be communicated in a timely manner to all pertinent providers and staff.
- Remain current with CMS/Federal guidelines (i.e., federal register, transmittals and LCD's). Review all updates published daily and distribute information to providers and staff.
- Identifies specific aberrances and atypical billing. Identify potential risks to the organization and ensure compliance to policies.
Required Education and Experience : High School diploma or equivalent. A minimum of 2-3 years in healthcare reimbursement & or coding experience. Knowledge in medical terminology and anatomy. Knowledge of insurance reimbursement, principles, and practice. Proficiency with Microsoft Office. : Certification required: American Academy of Professional Coders (AAPC) – CPC or equivalent organization, American Health Information Management Association, AHIMA –CCS) for a minimum of 2 years. CRC (Certified Risk Coder) certification obtained within 6 months of date of employment. This position is not remote.
Preferred Education and Experience : Knowledge of Client-IDX, Epic,& Cerner for retrospective or concurrent documentation reviews.
Source : Staff Icons
