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CODING & COMPLIANCE ASSOCIATE SUMMARY:

Performs all aspects of coding and adheres to corporate compliance and practice compliance programs.


ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Performs coding by ensuring the correct interpretation of charge ticket and supporting case information for input into Connect.
  • Performs charge entry and registration processes and procedures.
  • Monitors coding and adherence to the correct coding standards.
  • Ensures the correct linking of procedure and diagnosis codes.
  • Monitors the selection of medical codes.
  • Reviews and balances charge summaries.
  • Understands and adheres to PPM Corporate Compliance Program.
  • Identifies areas of risk surrounding corporate compliance.
  • Reports compliance violations.
  • Measures and reports on quality check points and criteria.
  • Performs other medical billing, payment entry, account modifications and follow up as needed.
  • Performs other activities and responsibilities as assigned.
  • Follows Company and Department policies and procedures, as set out by Company management.
  • Completes job duties and assignments timely, accurately and with a professional attitude and appearance.
  • Maintains a positive and cooperative relationship with other Company personnel.
  • Maintains a regular, predictable attendance and has the ability to keep a regular work schedule.

POSITION REQUIREMENTS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


Education and/or Experience—

High school diploma or general education degree (GED) and one (1) year of related experience; or equivalent combination of education and experience. AHIMA credential of RHIT or RHIA (or credential-eligible for RHIT/RHIA) or AHIMA credential of CCS or CCS-P preferred (American Academy of Professional Coders credential of CPC accepted in lieu of CCS or CCS-P).


Skills and Other Capabilities—

  • Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
  • Ability to write reports, business correspondence, and procedure manuals.
  • Ability to effectively present information and respond to questions from staff, clients, supervisors and managers.
  • Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
  • Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
  • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
  • Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
  • Possess the organizational skills to manage and prioritize a multi-task position.
  • Possess interpersonal skills necessary to successfully interact with clients and Company staff.
  • Must maintain telephone and personal etiquette to effectively deal with clients, vendors, peers, and management even under stressful conditions.
  • Must develop an excellent understanding of the organizations proprietary software and integrated third-party software.
  • Must be familiar with Microsoft® Excel, Word, and Outlook.
  • Must understand HIPAA, CMS Part D and Medicare Advantage regulations and laws.
  • Must understand regulatory compliance concepts, practices, and procedures.
  • Must have knowledge of physiology, anatomy, and medical terminology.
  • Must have advanced knowledge of ICD-9-CM and CPT-4 classification systems/coding guidelines.

If you would like to apply for this position, please e-mail your resume and cover letter to careers@ppmconnect.com.