Interim Certified Medical Coder

Our Dallas, TX client has immediate needs for multiple Interim Certified Medical Coders on a contract basis.

This will be long term contract position allowing the Interim Certified Medical Coders to work on a remote basis.

Interim Certified Medical Coder

ESSENTIAL FUNCTIONS

1. Serves as a professional billing integrity leader, under supervision of Sr. Professional Billing Integrity Supervisor, to develop and conduct individual or group presentations on coding, billing and compliance topics, based on new regulatory and professional coding industry information; pre-bill professional charge review findings, or special projects requested by leadership. This may include medical record audits, invoice analysis, and review of internal reports (e.g., Charge Analyzer, Code Correct), denials, external audit findings, etc. Assists Sr. Professional Billing Integrity Educator or Supervisor with development and deployment of any action plans required.

2. Conducts standardized new provider coding and compliance training (“onboarding”) for physicians, advanced practice providers and other professional practitioners, in two or more service lines/divisions. Training may be conducted in an individual or group setting.

3. Performs post-onboarding pre-bill review of professional charges and follow-up with new providers to confirm understanding of procedure, modifier and diagnosis code assignment, as well as, documentation requirements to promote billing compliance. Supporting two or more service lines, with supervision by Sr. Professional Billing Integrity Supervisor.

4. Conducts increasingly independent reviews on adequacy of medical record documentation, to support the procedure, modifier and diagnosis coding of evaluation and management (E& M) services and low-moderate complexity diagnostic/therapeutic services, billed by physicians, practitioners or billing staff, in two or more service areas. Working with Sr. Professional Billing Integrity Supervisor, develops reports that summarize outcomes. Provides input on recommended corrective action plans.

5. Research coding, documentation and reimbursement policy questions or problems submitted by physicians, practitioners, supported-departments, billing staff and others, to ensure compliance with specific payer and/or government regulations. Assist Senior Billing Integrity supervisor with responses. Escalates issues beyond their scope to Senior Billing Integrity Supervisor or Manager.

6. In coordination with the Compliance Office, support and/or conduct Billing Compliance risk-based audits.

7. Complete charge review and follow-up EPIC work queue assignments, within department timeliness standards, under guidance of the Senior Billing Integrity supervisor. Assists with quality assurance reviews for internal or contractor staff to verify the coding or other work is consistent and supported by regulations

MINIMUM QUALIFICATIONS

EDUCATION/EXPERIENCE

five (5) years of experience in a professional billing environment with emphasis on coding, auditing and compliance responsibilities is required. Certification one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS) or a Certified Medical Coder (CMC) is required. CPMA is desired. Associates degree or two years of college is desired.

Five (5) years of experience in a professional billing environment with emphasis on coding, auditing and compliance responsibilities is required. Certification one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS) or a Certified Medical Coder (CMC) is required. CPMA is desired. Associates degree or two years of college is desired.