Arizona Community Physicians

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Certified Professional Coder (Non-remote position)

at Arizona Community Physicians

Posted: 9/26/2019
Job Status: Full Time
Keywords:

Job Description

Description

Become part of Arizona Community Physicians (ACP), Arizonas largest and most successful physician-owned medical group.  ACP  is  a patient-centered organization consisting of  approximately 800 employees. Our  group includes  170 providers in the specialties of family medicine, internal medicine,  geriatrics, pediatrics, endocrinology, rheumatology, dermatology, and gynecology. We are located in 58 locations of varying sizes in Tucson, Oro Valley and Green Valley. Our dynamic group offers lots of opportunities for professional growth and personal satisfaction.

Job Summary

Audits medical provider clinical documentation while adhering to Medicare/Medicaid billing regulations and Risk Adjustment (RAF) guidelines.  Identifies areas for coding improvement and effectively communicates with providers and staff to review findings and best practices for medical coding.  Performs in a professional manner, exercising good judgment and ethical standards.  Interacts effectively and builds respectful working relationships across the organization.  Demonstrates integrity by adhering to high standards of personal and professional conduct.  Must be reliable and have the ability to maintain a high level of confidentiality within all aspects of job performance.

Skills/ Requirements

Responsibilities

Performs coding services while meeting daily production and quality goals

Performs audit activities including review of medical chart coding and billing documentation

Partners with providers and staff to improve quality and efficiencies in coding and documentation of provider claims which involves educating and coaching on compliant coding practices and risk adjustment guidelines

Maintains excellent documentation of all reviews, methodologies employed, results and corrective actions implemented and monitored

Appropriately uses coding principles to code to the highest specificity while complying with CMS regulations and company goals and policies

Reviews CMS and insurance bulletins, newsletters and periodicals to maintain policies and stay abreast of current coding issues, trends and changes

Understands and adheres to The Health Insurance Portability and Accountability Act (HIPPA) and CMS Coding requirements

Maintains knowledge of policies and procedures and performs in accordance with the ACPs policies and procedures, applicable regulatory requirements, external laws and accreditation standards

Facilitates and supports a culture of compliance, ethics and integrity

Maintains professional certifications

Travel to office locations will be required

Performs other duties and responsibilities as required

Qualifications

Minimum 3 years experience coding outpatient Evaluation & Management (E/M) Services, preferably Primary Care

Certified Professional Coder (CPC) certification

Advanced knowledge of  ICD-10, CPT and HCPCS

Knowledge of HCC codes and the Medicare Advantage "Risk Adjustment" process

Thorough understanding of healthcare compliance with experience in auditing E/M services and providing professional constructive feedback in regard to billing and documentation practices

Thorough understanding of Medicare/Medicaid billing regulations and documentation guidelines

Strong knowledge of chart auditing/abstracting process

Effective communication, relationship-building and interpersonal skills

Exceptional attention to detail and proficiency in Microsoft Word and Excel

Skill / Requirements

 

Responsibilities

Performs coding services while meeting daily production and quality goals

Performs audit activities including review of medical chart coding and billing documentation

Partners with providers and staff to improve quality and efficiencies in coding and documentation of provider claims which involves educating and coaching on compliant coding practices and risk adjustment guidelines

Maintains excellent documentation of all reviews, methodologies employed, results and corrective actions implemented and monitored

Appropriately uses coding principles to code to the highest specificity while complying with CMS regulations and company goals and policies

Reviews CMS and insurance bulletins, newsletters and periodicals to maintain policies and stay abreast of current coding issues, trends and changes

Understands and adheres to The Health Insurance Portability and Accountability Act (HIPPA) and CMS Coding requirements

Maintains knowledge of policies and procedures and performs in accordance with the ACPs policies and procedures, applicable regulatory requirements, external laws and accreditation standards

Facilitates and supports a culture of compliance, ethics and integrity

Maintains professional certifications

Travel to office locations will be required

Performs other duties and responsibilities as required

Qualifications

Minimum 3 years experience coding outpatient Evaluation & Management (E/M) Services, preferably Primary Care

Certified Professional Coder (CPC) certification

Advanced knowledge of ICD-9, ICD-10, CPT and HCPCS

Knowledge of HCC codes and the Medicare Advantage "Risk Adjustment" process

Thorough understanding of healthcare compliance with experience in auditing E/M services and providing professional constructive feedback in regard to billing and documentation practices

Thorough understanding of Medicare/Medicaid billing regulations and documentation guidelines

Strong knowledge of chart auditing/abstracting process

Effective communication, relationship-building and interpersonal skills

Exceptional attention to detail and proficiency in Microsoft Word and Excel

Possess a valid Arizona Driver's license