Community Health Systems Physician Coding Review Specialist in Franklin, Tennessee
Community Health Systems ("CHSPSC, LLC") is one of the leading operators of general acute care hospitals. The organization's affiliates own, operate, or lease more than 100 hospitals in 20 states, with an aggregate of approximately 21,000 licensed beds. The consolidated organization owns and leases community hospitals that offer quality, cost-effective healthcare including a range of inpatient medical and surgical services, outpatient treatment and skilled nursing care. In over 60 percent of the markets served, CHS-affiliated hospitals are the sole provider of healthcare services.
CHSPSC, LLC seeks a Physician Coding Review Specialist for its Franklin, TN, headquarters Physician Coding & Documentation team.
Reviews medical record documentation to select and sequence the appropriate CPT, HCPCS and ICD procedural coding. Participate in other coding related reviews and analysis at the direction of the CHS leadership team.
Essential Duties and Responsibilities:
•Reviews and analyzes documentation against billed procedures to ensure accurate coding of diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements
•Makes corrections as needed to ensure accurate coding and billing and reimbursement processing.
•Communicates with medical providers to clarify missing or inadequate medical record information required to complete the coding assessment.
•Submits a daily report of coding results to the provider via the clinic coordinator
•Prepares a comprehensive report based on the findings of the documentation review for prebill providers.
•Follows the compliance plan in determining the scope and duration of the prebill coding process.
•Assists the organization s compliance officers, as directed, to research and investigate complaints, concerns or questions relative to compliance issues.
•Serves as a resource and liaison in the organization for coding related topics, issues and questions.
•Maintains strict confidentiality of provider information, patient data, financial and billing information.
•Reports noncompliance issues detected through auditing and monitoring to the department supervisor and the Senior Director of Physician Coding and Documentation.
•Complies with all policies and procedures of the Corporate Compliance Program.
•Attends meetings as requested, which may necessitate working in the evening or very early morning.
•Assists with special projects as assigned by the supervisor or the Senior Director of Physician Coding and Documentation.
•Work with other staff members to inspire teamwork and promote cooperation.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
•Fluent in the English language
•Excellent oral, written and presentation skills required
•Possess a vast knowledge of CPT, ICD and HCPCS coding and reimbursement issues for physician offices and clinics
•Strong knowledge of 1995 and 1997 Documentation guidelines
•Excellent understanding and comprehension of medical terminology
•Strong leadership, interpersonal and problem solving skills
•Must have the ability to balance and juggle multiple tasks, projects and requests
•Must be able to make sound decisions objectively and follow through
•Ability to communicate effectively any issues or weaknesses with coding and documentation to the providers and/or CHS management in a one-on-one or classroom setting
•Must be detail oriented and analytical
•Able to interact confidently with providers, staff, corporate CHS management and/or other CHS affiliated personnel
•Normal visual and auditory activity is required
•Emotional and mental stability required to deal with periods of high stress
•Possess clinical knowledge and ability to evaluate and summarize clinical records to support successful appeal
•Ability to define problems, collect data, establish facts, and draw valid conclusions.
•Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
To perform this job successfully, an individual should have knowledge of Word Processing software; Spreadsheet software; practice management software and electronic medical records software.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Must be able to sit for prolonged periods of time, work on keyboard and view monitor for majority of the work day. Public speaking ability is required. Must be able to travel by both airplane and automobile, have the ability to carry luggage, computer cases and resources material long distances, whenever necessary. Must be able to lift carry-on luggage.
Certificates and Licenses:
CPC or CCS-P
High School Diploma and/or GED
Minimum of 5 years experience working with physician offices or clinics working with diagnostic and procedure coding and/or medical billing
Requires extensive knowledge of CPT, HCPCS, ICD coding, medical terminology and the AMA s 1995 and 1997 Documentation Guidelines
Job: Corporate Positions
Organization: CHS Corporate
Requisition ID: 1827803