Medical Physician Job in Oklahoma City, Oklahoma : OK 73127
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Coding Quality Assurance Advisor – Pro Fee/Physician |Surgical Coding
Coding Quality Assurance Advisor – Pro Fee/Physician |Surgical Coding Job DescriptionIntermedix is an international health care and emergency management solutions company committed to “serving those who save lives." Headquartered in Nashville, TN, the company has 30 offices around the world—29 of which are located in the United States, and three of which are located in the United Kingdom, New Zealand and Lithuania.
For more than 35 years, Intermedix has been a leader in pioneering innovations in data analytics and cloud-based technology to deliver best-in-class revenue cycle management, practice management and emergency management solutions to clients in over 25 countries. Intermedix supports more than 500,000 emergency preparedness and response incidents around the world and enables more than 15,000 health care providers to focus on delivering excellence in patient care.
Our team members thrive in our collaborative work environment where they contribute to innovative, meaningful work that makes an impact in communities around the world. If you’re looking for a purposeful and meaningful career at a global company, then Intermedix may be the place for you.
Oklahoma City Medical Physician Job
Coding Quality Assurance Advisor – Pro Fee/Physician |Surgical Coding Job Requirements
Coding Quality Assurance Advisor – Pro Fee/Physician |Surgical Coding Specialist
Under minimal supervision, our Coding Quality Assurance Advisor manages and conducts detailed analytical reviews to determine the accuracy of pro-fee claims by comparing the billing records to the provider documentation. These audits compare medical record documentation to the itemized bill in accordance to governmental, coding and billing rules and regulations to identify opportunities for improved compliance and revenue opportunities through more effective documentation or improved charge capture processes. This position requires working knowledge auditing both E&M and surgical CPT, HCPCS, ICD-10, and modifiers.
- Performs monthly reviews of each team member's coded patient charts (before entry into the system), utilizing the medical charts (both paper and electronic) and previously applied codes (by the team member) and compares both to ensure accuracy, while making written notes of findings and communicating those findings with both team members and leadership.
- May be required to notify team members directly and individually via e-mail or telephone of instances where serious deficiencies necessitate focused reviews.
- Prepares monthly memorandum to each team member listing the findings of that month's review.
- Performs monthly quality assurance reviews of tenured coding team members and probationary reviews for new or disciplined team members and provides feedback as required.
- Prepares monthly statistical reports for submission to the Medical Coding Team Leader.
- Prepares monthly informational e-mail memoranda to all Medical Coding Team Members listing areas of deficiency that need focused attention, as necessary.
- Discusses with the Coding QA Management and Coding Management issues/questions/problems which may arise.
- Maintain acceptable levels of attendance and punctuality as specified in company and departmental policies.
- Meet routine deadlines and work schedules as well as timely and accurate completion of special projects and any other duties as assigned.
- Understand, support, enforce and comply with company policies, procedures and Standards of Business Ethics and Conduct.
- Display a positive attitude as well as professional, polite, considerate and courteous conduct and treatment of others in the course of duties.
- Must possess a HS Diploma or GED
- Must have a current CPC certification
- Must have surgical coding experience
- Must maintain accuracy level of 95% or greater
- Work closely with Medical Records staff to ensure accurate pulling of records
- Monitor and resolve coding edits, question and denials in a timely manner to ensure optimal reimbursement
- Utilize computer applications and resources essential to completing the coding process efficiently
- Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/or clarification to accurately complete the coding process
- Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits.
- Minimum of five (5) years of direct experience in coding pro-fee claims
- Knowledge of various coding systems utilized in healthcare (CPT, HCPCS, ICD-10)
- Demonstrated in-depth knowledge and ability to conduct comprehensive and detailed audits of billing records for appropriate medical record documentation
- Coding expertise with a demonstrated ability to perform concurrent or retrospective coding audits
- Knowledge of coding and billing rules and regulations
- Knowledge of medical terminology, anatomy and physiology
- Working knowledge of the revenue cycle process, regulatory standards, and billing guidelines
- Ability to analyze audit results to identify patterns, trends, variances and opportunities
- Experience includes working in a collaborative environment.
- Excellent, fast and accurate computer skills using Microsoft Office applications (Excel, Word, PowerPoint).
- Ability to quickly learn other software applications as assigned
- Ability to code multi-specialty services
- Proficiency in medical computer information systems and various software packages
- Ability to maintain strict confidentiality.
- Excellent communication skills with the ability to communicate clearly both verbally and in writing and be able to articulate complex ideas for all levels of audiences.
- Be a self-starter who is accountable and requires minimal direction and supervision; a person who is open to new ideas; and a creative and flexible individual who is comfortable working in a large, complex organization.
- Possess the personal characteristics of professionalism, credibility, commitment to high standards, innovation, discriminating judgment and accountability.
- Must possess a HS Diploma or GED
- A minimum of 2 years medical coding experience with Intermedix preferred
- Strong working knowledge of Intermedix Coding Manual
- Strong working knowledge of ICD-10, CPT, and Tracker Codes
- Possess effective communication, counseling, interpersonal and time-management skills.
- Proper use of English grammar, punctuation and sentence formation in verbal and written “Intermedix is an Equal Opportunity, Affirmative Action employer."