Coding Compliance Analyst

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Job description

Coding Compliance Analyst

US-OR-

Job ID: 24-38885
Type: Regular Full-Time
Homebased EE Oregon

Overview

Remote Position (OR/WA Only)

This is a remote position incumbents, who reside in Oregon or Washington only. There may be occasional situations that require work to be performed on-site at an assigned Legacy Health location. All new hires are required to come to a designated Legacy Health office location in Portland, Oregon prior to their start date for a new hire health assessment and to complete new hire paperwork. This position may require initial training and orientation to be site-based, before transitioning to the remote schedule.

Responsibilities

You recognize that your coding and compliance skills serve a larger mission within the Legacy community, and that is making life better for others. As you develop, implement and monitor systems to meet Medicare and other payor guidelines for documentations, you are continuing the excellence that guides Legacy in all we do. If this how you feel about your work, we invite you to consider this opportunity.

Compliance

Works closely with Regulatory department to support adherence to compliance policies relating to professional coding.

Provides new physician orientation related to regulatory compliance, documentation and coding guidelines.

Charge Capture

Analyzes physician practices to identify charge opportunities and ensure all billable services are captured.

Develops fee ticket and provides in-services to providers and staff on their use.

Oversees the set-up of new CPT Codes.

Updates and reviews fee tickets annually and ensures system files are updated accordingly.

Identifies need for and enlists consultant services as needed.

Participation in Reimbursement Analysis of Professional Services

Participates in reimbursement analysis to determine if denials relate to CPT or diagnostic coding.

Defines criteria for payor specific reimbursement for correct payment analysis.

Investigates payor response to new CPT/HCPCS codes.

Analyzes and documents the patient account cycle for each physician or physician line of business for timely and accurate processing.

Provider and Staff Training

Provides onsite initial and ongoing CPT and ICD-9 training to providers and staff.

Acts as a resource to physicians for CPT and diagnostic coding questions.

Performs regular audits to ensure compliance with coding and documentation guidelines. Provides feedback to physicians, both written and verbally, regarding coding and documentation accuracy.

Qualifications

Education:

Associates degree in business or healthcare, or equivalent experience, required.

Experience:

Minimum of two years healthcare experience required. CPT/ICD9 experience in a multi-specialty setting preferred. Database experience preferred.

Skills:

Strong communication skills, both verbal and written.

Ability to speak in front of large and small groups.

Proven ability to develop training programs, provide training and oversee work processes.

Excellent organizational skills and the ability to handle large volumes of work. Demonstrated understanding of insurance reimbursement and payment methodology. Competent in Microsoft Excel and Word software.

LEGACYS VALUES IN ACTION:

Follows guidelines set forth in Legacys Values in Action

Equal Opportunity Employer/Vet/Disabled

Compensation details: 30.16-43.15 Hourly Wage

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