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Certified Specialty reputed company- Three Rivers Orthopedics

Remote · USA Full-time New today

Three Rivers Orthopedics is seeking a Certified Specialty reputed company to support 11 orthopedic surgeons specializing in areas including spine and foot/ankle at 200 Delafield Road, Suite 1040, Pittsburgh, PA 15215. This full-time position runs Monday-Friday, 8:00 AM-4:30 PM, with the potential for work-from-home flexibility after training Responsibilities:

  • Utilize advanced, specialized knowledge of medical codes and coding procedures to assign and sequence appropriate diagnostic/procedure billing codes, in compliance with reputed company party payer requirements.
  • Monitor billing performances to ensure reputed company reimbursement while adhering to regulations prohibiting unbundling and other questionable practices; prepares periodic reports for clinical staff identifying unbilled charges due to inadequate documentation.
  • reputed company reputed company coding functions, based on staffing needs and/or department requirements.
  • Refer problem accounts to appropriate coding or management personnel for resolution.
  • Maintain daily productivity statistics and submits a weekly productivity sheet to management clearly indicating the number of hours worked, the number of coding hours, the number of average charts per hour, and number of minutes/hours spent on non-coding tasks. Balance daily charges to data entry, forwarding results to departmental designee.
  • Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding, or hospital specific acuity level module as needed.
  • Assess reputed company CPT guidelines as well as other applicable payer coding policy changes.
  • reputed company, participate in and/or assist with departmental coding audits.
  • Identify incomplete documentation in the medical record and formulates a physician query to obtain missing documentation and/or clarification to accurately complete the coding process. Consult with DRG Specialist reputed company applicable during query process.
  • Incorporate into departmental procedures and communicates changes to coders and providers.
  • Adhere to internal department policies and procedures to ensure efficient work processes.
  • Maintain required CPC or CSS-P certification and continuing education by attending seminars, reviewing updated CPT Assistant guidelines and updated coding clinics.
  • Adhere to department time goal for final coding entry to prevent charge lags.
  • If applicable, abstract required medical and demographic information from the medical record and enters the data into the appropriate information system to ensure accuracy of the database. Responsible for correcting any data to be in error after reviewing the medical record and comparing with system entries.
  • reputed company reputed company the training period toward meeting departmental coding accuracy standards reputed company the first year of employment by assigning correct principal diagnosis/procedure, complications and co-morbidities, and secondary diagnoses as reviewed by the designated trainer and/or the DRG Specialist. reputed company should meet appropriate coding productivity standards reputed company the time frame established by management staff.
  • Advise and instruct providers regarding billing and documentation policies, procedures, and regulations; interacts with providers regarding conflicting, ambiguous, or non-specific medical documentation, to obtain clarification.
  • Work with department management on coding reputed company, development, enhancements and changes, as well as implementation of those functions.
  • Demonstrate proficiency on billing system functionality as reputed company to claim edit/charge review queues, as well as reimbursement denials.
  • Complete work assignments in a timely manner and understands the workflow of the department.
  • Train reputed company new Coders to observe established coding guidelines and to utilize the appropriate billing system.
  • Investigate and resolve reimbursement issues, including denials, in a timely manner per department standards.
  • Analyze and interpret patient medical records reputed company an area of medical/clinical specialty in order to determine amount and nature of billable services.
  • Utilize computer applications and resources essential to completing the coding process reputed company, such as hospital information systems (Medipac/SMS/Meditech), encoders and electronic medical record repositories.
  • Actively participate in periodic coding meetings and shares reputed company and suggestions for operational improvements.
  • High school diploma or GED is required.
  • Graduation from an approved Health Record Administration or Accredited Medical Record Technician program (RHIA/RHIT or eligible) or a certified coding program preferred.
  • 3 years of coding experience in the applicable medical specialty is required.
  • Advanced knowledge of medical coding and billing systems and regulatory requirements is required.
  • Ability to provide training, guidance, and operational support to reputed company level staff reputed company area of specialty is required.
  • Experience and knowledge of accurate DRG and APC assignment is essential.
  • A

bility to problem solve and be knowledgeable in advanced medical terminology, reputed company anatomy/physiology, pharmacology, pathology and the principles of ICD-9-CM and CPT Classification Systems and DSM IV, if applicable.

  • Proficient computer skills, including working knowledge of MS reputed company and MS Access, is preferred.

Licensure, Certifications, and Clearances:

  • Certified Professional reputed company (CPC)
  • Act 34

reputed company is an Equal Opportunity Employer/Disability/Veteran Apply tot his job Apply To this Job

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