CERTIFIED MEDICAL CODING SPECIALIST (ON-SITE)
Riverside Healthcare
1 day ago
Full-time
On-site
Kankakee, Illinois, United States
Occupational Therapist
Overview
The Professional Coding Compliance Specialist provides revenue cycle support to Riverside Medical Group and its coding team by regularly auditing provider documentation and corresponding coding to ensure correct, complete and compliant practices that fully support diagnoses reported and charges submitted for services rendered, meet regulatory and payor-specific requirements, and accurately describe the patient encounter; providing feedback and education to providers and coders based on audit results, regulatory changes, and industry trends; assisting with orientation of new providers, residents/fellows, and new members of the coding team.
Essential Duties
Completes timely audits of assigned providers and coders for accurate, complete, and compliant ICD-10-CM and CPT/HCPCS code assignment, ensuring that documentation supports the diagnoses reported, E/M level selected, and CPT/HCPCS codes submitted for services rendered during the episodes of care reviewed
Reviews audit findings with assigned providers and coders, providing real-time education on opportunities identified and offering objective supporting documentation (e.g., current coding conventions, regulatory/payor-specific requirements, risk-adjustment guidelines, organization-specific policies) to support findings and use as reference
Documents audit results in designated Excel log as soon as review is completed
Immediately reports adverse audit trends, potential areas of risk, and compliance concerns to management
Assists coding compliance lead in creating and publishing monthly provider newsletter
Collaborates with coding compliance team and provider-focused coding manager to develop and maintain current coding guidelines for Riverside Medical Group as a whole and its specialists to ensure compliance and consistency across practices and their assigned coding teams
Participates in developing and presenting provider and coder education programs as requested
Assists coding compliance lead in maintaining orientation materials for new providers, residents, and fellows that reflect current coding and documentation rules and requirements
Assists provider-focused coding manager and coding compliance lead in orienting and educating new team members as requested
Serves as coding compliance resource to Riverside Medical Group and Riverside Medical Center as requested
Assists in provider-focused coding and charge entry as needed to meet fiscal deadlines and backfill staff vacancies
Responsibilities
Required Experience
Minimum three years current ICD-10-CM and CPT/HCPCS (including E/M assignment) coding experience in a multi-specialty medical practice or comparable coding experience required
Required Licensure/Education
High school graduate or equivalent required.
AAPC/CPC (Certified Professional Coder) required
AAPC/CPMA (Certified Professional Medical Auditor) strongly recommended at hire; required within two years of hire
AAPC/CRC (Certified Risk-Adjustment Coder) strongly recommended
Preferred Education
Associate degree in health-related field preferred
Formal education in ICD-10-CM and CPT/HCPCS coding principles and assignment maintained by relevant continuing education
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
Our Commitment to You:
Riverside Healthcare offers a comprehensive suite of Total Rewards: benefits and nationally rated employee well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more so your journey at and away from work is remarkable. Our Total Rewards package includes:
Compensation:
Base compensation within the positions pay range based on factors such as qualifications, skills, relevant experience, and/or trainin
Premium pay such as shift differential, on-call
Opportunity for annual increases based on performance
Benefits - .5 to 1.0 FTE:
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Health Savings and Flexible Spending Accounts for eligible health care and dependent care expenses
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Benefits - .001 to .49 FTE:
Paid Leave Hours accrued as you work
Employee Health Requirements
Exposure/Sensory Requirements:
Exposure to:
Chemicals: NA
Video Display Terminals: Average
Blood and Body Fluids: None
TB or Airborne Pathogens: None
Sensory requirements (speech, vision, smell, hearing, touch):
Speech: Needed for presentations/training, telephone communication, facilitate meetings.
Vision: Needed to read computer screens and printouts, memos, communications, documentation, and literature.
Smell: Electrical/fire safety.
Hearing: Needed for telephone communications, meetings, and equipment operating characteristics.
Touch: Needed to write, do computer entry, filing.
Activity/Lifting Requirements:
Percentage of time during the normal workday the employee is required to:
Sit: 55%
Twist: 0%
Stand: 20%
Crawl: 0%
Walk: 20%
Kneel: 0%
Lift: 0%
Drive: 0%
Squat: 0%
Climb: 0%
Bend: 5%
Reach above shoulders: 0%
The weight required to be lifted each normal workday according to the continuum described below:
Up to 10 lbs: Frequently
Up to 20 lbs: Occasionally
Up to 35 lbs: Occasionally
Up to 60 lbs: Occasionally
Up to 75 lbs: Not Required
Up to 100 lbs: Not Required
Over 100 lbs: Not Required
Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):
Putting away supplies.
Lift above the head occasionally to place boxes on high storage shelves.
Carry boxes up and down the stairs - distances up to 100 feet.
Maximum consecutive time (minutes) during the normal workday for each activity:
Sit: 30
Twist: .5
Stand: 30
Crawl: 0
Walk: 2
Kneel: 0
Lift: 5
Drive: 30
Squat: 1
Climb: .5
Bend: .5
Reach above shoulders: .5
Repetitive use of hands (Frequency indicated):
Simple grasp up to 15 lbs.
Normal weight: continuous
Pushing &pulling Normal weight: 50-200#
Fine Manipulation: Computer Keyboard and mouse.
Repetitive use of foot or feet in operating machine control: Not Required
Environmental Factors & Special Hazards:
Environmental Factors (Time Spent):
Inside hours: 8.0
Outside hours : 0
Temperature: Normal Range
Lighting: Average
Noise levels: Average
Humidity: Normal
Atmosphere:
Special Hazards:
Protective Clothing Required: Gloves when handling blood and body fluids.
Pay Range
USD $28.83 - USD $37.13 /Hr
The Professional Coding Compliance Specialist provides revenue cycle support to Riverside Medical Group and its coding team by regularly auditing provider documentation and corresponding coding to ensure correct, complete and compliant practices that fully support diagnoses reported and charges submitted for services rendered, meet regulatory and payor-specific requirements, and accurately describe the patient encounter; providing feedback and education to providers and coders based on audit results, regulatory changes, and industry trends; assisting with orientation of new providers, residents/fellows, and new members of the coding team.
Essential Duties
Completes timely audits of assigned providers and coders for accurate, complete, and compliant ICD-10-CM and CPT/HCPCS code assignment, ensuring that documentation supports the diagnoses reported, E/M level selected, and CPT/HCPCS codes submitted for services rendered during the episodes of care reviewed
Reviews audit findings with assigned providers and coders, providing real-time education on opportunities identified and offering objective supporting documentation (e.g., current coding conventions, regulatory/payor-specific requirements, risk-adjustment guidelines, organization-specific policies) to support findings and use as reference
Documents audit results in designated Excel log as soon as review is completed
Immediately reports adverse audit trends, potential areas of risk, and compliance concerns to management
Assists coding compliance lead in creating and publishing monthly provider newsletter
Collaborates with coding compliance team and provider-focused coding manager to develop and maintain current coding guidelines for Riverside Medical Group as a whole and its specialists to ensure compliance and consistency across practices and their assigned coding teams
Participates in developing and presenting provider and coder education programs as requested
Assists coding compliance lead in maintaining orientation materials for new providers, residents, and fellows that reflect current coding and documentation rules and requirements
Assists provider-focused coding manager and coding compliance lead in orienting and educating new team members as requested
Serves as coding compliance resource to Riverside Medical Group and Riverside Medical Center as requested
Assists in provider-focused coding and charge entry as needed to meet fiscal deadlines and backfill staff vacancies
Responsibilities
Required Experience
Minimum three years current ICD-10-CM and CPT/HCPCS (including E/M assignment) coding experience in a multi-specialty medical practice or comparable coding experience required
Required Licensure/Education
High school graduate or equivalent required.
AAPC/CPC (Certified Professional Coder) required
AAPC/CPMA (Certified Professional Medical Auditor) strongly recommended at hire; required within two years of hire
AAPC/CRC (Certified Risk-Adjustment Coder) strongly recommended
Preferred Education
Associate degree in health-related field preferred
Formal education in ICD-10-CM and CPT/HCPCS coding principles and assignment maintained by relevant continuing education
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
Our Commitment to You:
Riverside Healthcare offers a comprehensive suite of Total Rewards: benefits and nationally rated employee well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more so your journey at and away from work is remarkable. Our Total Rewards package includes:
Compensation:
Base compensation within the positions pay range based on factors such as qualifications, skills, relevant experience, and/or trainin
Premium pay such as shift differential, on-call
Opportunity for annual increases based on performance
Benefits - .5 to 1.0 FTE:
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Health Savings and Flexible Spending Accounts for eligible health care and dependent care expenses
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Benefits - .001 to .49 FTE:
Paid Leave Hours accrued as you work
Employee Health Requirements
Exposure/Sensory Requirements:
Exposure to:
Chemicals: NA
Video Display Terminals: Average
Blood and Body Fluids: None
TB or Airborne Pathogens: None
Sensory requirements (speech, vision, smell, hearing, touch):
Speech: Needed for presentations/training, telephone communication, facilitate meetings.
Vision: Needed to read computer screens and printouts, memos, communications, documentation, and literature.
Smell: Electrical/fire safety.
Hearing: Needed for telephone communications, meetings, and equipment operating characteristics.
Touch: Needed to write, do computer entry, filing.
Activity/Lifting Requirements:
Percentage of time during the normal workday the employee is required to:
Sit: 55%
Twist: 0%
Stand: 20%
Crawl: 0%
Walk: 20%
Kneel: 0%
Lift: 0%
Drive: 0%
Squat: 0%
Climb: 0%
Bend: 5%
Reach above shoulders: 0%
The weight required to be lifted each normal workday according to the continuum described below:
Up to 10 lbs: Frequently
Up to 20 lbs: Occasionally
Up to 35 lbs: Occasionally
Up to 60 lbs: Occasionally
Up to 75 lbs: Not Required
Up to 100 lbs: Not Required
Over 100 lbs: Not Required
Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):
Putting away supplies.
Lift above the head occasionally to place boxes on high storage shelves.
Carry boxes up and down the stairs - distances up to 100 feet.
Maximum consecutive time (minutes) during the normal workday for each activity:
Sit: 30
Twist: .5
Stand: 30
Crawl: 0
Walk: 2
Kneel: 0
Lift: 5
Drive: 30
Squat: 1
Climb: .5
Bend: .5
Reach above shoulders: .5
Repetitive use of hands (Frequency indicated):
Simple grasp up to 15 lbs.
Normal weight: continuous
Pushing &pulling Normal weight: 50-200#
Fine Manipulation: Computer Keyboard and mouse.
Repetitive use of foot or feet in operating machine control: Not Required
Environmental Factors & Special Hazards:
Environmental Factors (Time Spent):
Inside hours: 8.0
Outside hours : 0
Temperature: Normal Range
Lighting: Average
Noise levels: Average
Humidity: Normal
Atmosphere:
Special Hazards:
Protective Clothing Required: Gloves when handling blood and body fluids.
Pay Range
USD $28.83 - USD $37.13 /Hr