Position Summary: Coordinates all coding for Omni Family Health practices to ensure consistency, to meet compliance guidelines, and to ensure appropriate and effective reimbursement. Supports Omni Family Health Physicians and hospital-based providers with monthly physician reimbursement and act as a back up to the department supervisor. Develops policies and procedures to support coding guidelines. Provides education to the coding staff in conjunction with department educator audits and findings.
The following are essential job accountabilities:
- Coordinates scheduling and work assignments. Establishes and monitors coding workflows, employee productivity, and coding quality. Evaluates staff performance and prepares NEO for new hires.
- Performs coding for new providers and clinics to OMNI. Assists with the development of new policies and procedures and coding practices to meet Compliance guidelines and to ensure appropriate and effective reimbursement.
- Acts in a leadership capacity with key areas for initiatives such as Physician education, ICD-10 initiatives and successful implementation.
- Coordinates with collections department to resolve clinical appeals and provide clinical documentation in response to coding denials/appeals identified during claims submission process and during end of month analysis.
- Acts as a coding resource for OMNI physicians and clinic staff.
- Schedules and coordinates monthly and quarterly coder educational seminars. Provides documentation and feedback to Supervisor, Coding & Compliance as needed to support certified coders on-going education.
- Supports the incoming charges processed through NextGen EHR including monthly reconciliation and finalizing.
- Performs other related duties as assigned or requested.
- Ability to work under pressure.
- Ability to demonstrate effective communication skills with providers and management staff.
- Ability to develop teaching and auditing tools to provide educational programs for physicians and billing staff.
- Proficient with excel and other Microsoft office products.
- Knowledge of 3M encoder and/or encoder pro software.
- HIPAA compliance – Responsible for enforcing compliance with all HIPAA regulations and requirements. Treats all member information confidential.
- Compliance – Ensure compliance with all local, state, and federal regulations.
- QA/QI – Participate in QA/QI activities and contribute towards the overall performance improvement of the organization.
- IT – Required learning and using the Electronic Health Record and Practice Electronic System and its components as required by the job functions and highlighted in the Policies and Procedures.
- All employees will participate in Patient Centered Home Health Model at Omni Family Health.
Qualifications, Education, and Experience
- High school diploma or GED
- CPC, CPCH, and/or CCS-P certification required
- Minimum of two years billing and accounts receivable experience in a physician practice or community health environment.
- Minimum of three years physician coding experience in a multi-specialty environment.
- Maintain annual coding certification requirements.
- Must have a working knowledge of coding rules, and third party payer requirements.
Responsible to: Director of Billing
Classification: Full-time, Exempt