Coding Research & Training Assistant

GENERAL PURPOSE:

The Coding Research and Training assistant is responsible for providing medical coding training and support for providers and staff based on needs identified by the Corporate Compliance Officer/Health Information Manager.

MAIN RESPONSIBILITIES & DUTIES:

• Works with Revenue Cycle, Operations and Clinical departments to provide provider and staff trainings including but not limited to the following areas:
  • ICD-10 application and guidelines
  • Evaluation and Management selection
  • Centricity Practice Solution training specific to ICD 10-and procedural coding
  • Auditing of provider diagnosis, procedural coding and documentation.
• Acts as a resource for questions related to HCPCS, CPT and ICD 10-coding.
• Evaluates the record for documentation consistency and adequacy during provider coding audits. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established reimbursement and special screening criteria.
• Researches codes and guidelines as it pertains to various providers, Informatics, billing and other departments as requested, to give accurate information for the purposes of billing, reporting and auditing.
• Assist in auditing, reviewing and reporting to appropriate parties, any findings on various audits done within the oversight of the Compliance program.
• Assists with training for all departments involving ICD-10-CM and CPT CM including, but not limited to Evaluation and Management section, Centricity Practice Solution.
• Collects and records data accurately on training received by staff.
• Trains in various clinical areas (Suboxone, HIV, 340B drugs etc.) to be audited to fully understand the policies and procedures for each area in order to assess, audit and report findings to the Compliance officer.
• Maintains audit records for outside auditing purposes as well as further internal auditing purposes.
• Prepares for audits by researching materials, policies, procedures and formulating a plan of action. Setting up spreadsheets for data and recording as required.
• Communicate audit progress and findings by preparing reports and providing information in meetings when requested.
• Assists the Compliance/Coding/HIM lead in reporting, educating, creating and implementing any policy and procedure necessary to ensure that all departments follow regulations according to the Compliance program.
• Assist the Compliance Officer with onsite audits as needed.
• Enhances compliance department and the organizations reputation by accepting responsibility for accomplishing new and different coding and compliance related requests; exploring opportunities for additional audits/monitoring to ensure the most robust compliance program possible.
• Also assists with the coding and HIM department with patient complaints, records requests, incident reports, correcting claims as requested by the Coders, and other duties as assigned.
• Travel as needed
• Maintains open communication with supervisor and all staff.
• Maintains confidentiality of all patients/personnel records.

QUALITIES & CHARACTERISTICS

• Maintains a professional relationship and positive attitude with co-workers, the public, patients and all Ampla Health’s staff, Board of Directors and vendors
• Maintains the highest professional ethics and is honest in dealing with people; is a model for all employees through his/her actions
• Strives to learn more and is receptive to learning different ways of doing things
• Displays enthusiasm toward the work and the mission of Ampla Health

PROFESSIONAL KNOWLEDGE, SKILLS & ABILITIES

• High School Diploma or GED
• Approved Coding certificate required. (CCS, CPC)
• Experience working in a compliance role preferred, but not required
• Knowledge of billing practices, auditing practices, various programs utilized in an outpatient clinic setting.
• Prior medical records review experience
• Experience in governmental programs as related to FQHC’s or other related clinical setting
• Centricity practice management system experience is a plus
• Data management responsibilities a plus
• Able to operate general office equipment, such as copiers, facsimile machine, etc.
• Working knowledge of Microsoft windows programs such as Word, Excel, Power Point
• Intermediate computer skills

COMMUNICATION SKILLS:

• Must have neat and legible handwriting
• Must be able to interact with patients/providers courteously and calmly
• Ability to communicate well with the public
• Exceptional verbal and written communication skills

WORKING CONDITIONS & PHYSICAL REQUIREMENTS

Works well with patients, co-workers and vendors in a generally comfortable environment office. Employee must possess the following physical requirements:

• May require prolonged sitting or standing
• Travel as needed
• Vision sufficient to read handwritten, typed and computer printed documents throughout the day
• Speech and hearing sufficient to receive and communicate detailed information clearly by phone and in person
• Motor skills sufficient to use and manipulate equipment
• Must have a high level of manual dexterity
• Physically able to sit, walk, or otherwise stand for long periods of time, frequent bending, stooping, and stretching. Repetitive hand, arm, and shoulder movements
• Able to lift up to 40 pounds

GENERAL PURPOSE:

The Coding Research and Training assistant is responsible for providing medical coding training and support for providers and staff based on needs identified by the Corporate Compliance Officer/Health Information Manager.

MAIN RESPONSIBILITIES & DUTIES:

• Works with Revenue Cycle, Operations and Clinical departments to provide provider and staff trainings including but not limited to the following areas:
  • ICD-10 application and guidelines
  • Evaluation and Management selection
  • Centricity Practice Solution training specific to ICD 10-and procedural coding
  • Auditing of provider diagnosis, procedural coding and documentation.
• Acts as a resource for questions related to HCPCS, CPT and ICD 10-coding.
• Evaluates the record for documentation consistency and adequacy during provider coding audits. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established reimbursement and special screening criteria.
• Researches codes and guidelines as it pertains to various providers, Informatics, billing and other departments as requested, to give accurate information for the purposes of billing, reporting and auditing.
• Assist in auditing, reviewing and reporting to appropriate parties, any findings on various audits done within the oversight of the Compliance program.
• Assists with training for all departments involving ICD-10-CM and CPT CM including, but not limited to Evaluation and Management section, Centricity Practice Solution.
• Collects and records data accurately on training received by staff.
• Trains in various clinical areas (Suboxone, HIV, 340B drugs etc.) to be audited to fully understand the policies and procedures for each area in order to assess, audit and report findings to the Compliance officer.
• Maintains audit records for outside auditing purposes as well as further internal auditing purposes.
• Prepares for audits by researching materials, policies, procedures and formulating a plan of action. Setting up spreadsheets for data and recording as required.
• Communicate audit progress and findings by preparing reports and providing information in meetings when requested.
• Assists the Compliance/Coding/HIM lead in reporting, educating, creating and implementing any policy and procedure necessary to ensure that all departments follow regulations according to the Compliance program.
• Assist the Compliance Officer with onsite audits as needed.
• Enhances compliance department and the organizations reputation by accepting responsibility for accomplishing new and different coding and compliance related requests; exploring opportunities for additional audits/monitoring to ensure the most robust compliance program possible.
• Also assists with the coding and HIM department with patient complaints, records requests, incident reports, correcting claims as requested by the Coders, and other duties as assigned.
• Travel as needed
• Maintains open communication with supervisor and all staff.
• Maintains confidentiality of all patients/personnel records.

QUALITIES & CHARACTERISTICS

• Maintains a professional relationship and positive attitude with co-workers, the public, patients and all Ampla Health’s staff, Board of Directors and vendors
• Maintains the highest professional ethics and is honest in dealing with people; is a model for all employees through his/her actions
• Strives to learn more and is receptive to learning different ways of doing things
• Displays enthusiasm toward the work and the mission of Ampla Health

PROFESSIONAL KNOWLEDGE, SKILLS & ABILITIES

• High School Diploma or GED
• Approved Coding certificate required. (CCS, CPC)
• Experience working in a compliance role preferred, but not required
• Knowledge of billing practices, auditing practices, various programs utilized in an outpatient clinic setting.
• Prior medical records review experience
• Experience in governmental programs as related to FQHC’s or other related clinical setting
• Centricity practice management system experience is a plus
• Data management responsibilities a plus
• Able to operate general office equipment, such as copiers, facsimile machine, etc.
• Working knowledge of Microsoft windows programs such as Word, Excel, Power Point
• Intermediate computer skills

COMMUNICATION SKILLS:

• Must have neat and legible handwriting
• Must be able to interact with patients/providers courteously and calmly
• Ability to communicate well with the public
• Exceptional verbal and written communication skills

WORKING CONDITIONS & PHYSICAL REQUIREMENTS

Works well with patients, co-workers and vendors in a generally comfortable environment office. Employee must possess the following physical requirements:

• May require prolonged sitting or standing
• Travel as needed
• Vision sufficient to read handwritten, typed and computer printed documents throughout the day
• Speech and hearing sufficient to receive and communicate detailed information clearly by phone and in person
• Motor skills sufficient to use and manipulate equipment
• Must have a high level of manual dexterity
• Physically able to sit, walk, or otherwise stand for long periods of time, frequent bending, stooping, and stretching. Repetitive hand, arm, and shoulder movements
• Able to lift up to 40 pounds