Remote Multispecialty Pro Fee Coder

Location Remote Office Santa Fe, NM 87501 Compensation Minimum Offer $21.70, Maximum Offer $33.14 Summary Build your Career. Make a Difference. Presbyterian is hiring a skilled Remote Multispecialty Pro Fee Coder to join our team. Type of Opportunity: Full time. Job Exempt: No. Job is based: Remote Workers New Mexico. Work Shift: Varied Days and Hours (United States of America). Responsibilities Presbyterian is seeking a talented Multispecialty Pro Fee Coder who, with minimal supervision, directly supports the following responsibilities of the Coding and Documentation Quality Assurance (CDQA) team: Implementation of and compliance to enterprise-wide and department coding policies and procedures for PHS. Compliance with all external regulatory agency coding rules and regulations. Demonstrate high-level proficiency in performing and/or managing on-site internal audits or reviews to assess compliance/quality monitoring performed by PHS/PMG departments. Serve as a resource on documentation, coding, billing and coding compliance questions. Work on special coding compliance related projects, develop and present educational programs, disseminate information to PHS/PMG departments and develop educational tools used to maintain compliance with regulations. Provide support via auditing and training the enterprise-wide corrective action plans for coding, audit, physician and clinician personnel identified as low performers; perform medical record and billing reviews of denied and appealed claims and take appropriate action to ensure accurate payment of claims. Coordinate review and tracking of appealed claims including the communication process with affected payers. Research and interpret all regulatory agency regulations. Some key responsibilities include: Act as liaison to the Manager, Information Services, Finance/Patient Financial Services, all hospitals, all PMG sites, PHP, Home Health, Albuquerque Ambulance, Compliance and all ancillary departments in addressing functional coding, auditing, compliance and training issues and problems. Interact with all levels of management. Maintain accurate, complete and timely documentation in either electronic or hard copy form. Adapt to frequently changing work priorities and schedules. Maintain and disseminate up-to-date technical knowledge of legal and regulatory information from all appropriate jurisdictions concerning the given business area, including updates and changes to ICD-9, ICD-10, CPT-4, HCPCS and APC. Research coding, billing and charging compliance issues, recommend and implement corrective action plans that assure compliance with regulatory agencies where appropriate. Identify risks, develop and follow up on action plans, identify lost revenue opportunities and any overpayments due to errors in coding and/or documentation, and provide compliance education. Assist in the creation of the CDQA Annual Audit Work‑plan by utilizing the OIG work plan, Medicare and Medicaid regulations, RAC and other audit agency focuses, as well as internal and external risk assessments. Use independent judgment in determining the reliability of data reviewed; recommend changes in existing practices to gain or maintain compliant behavior. Respond to inquiries and requests daily regarding coding and auditing issues and problems and ad‑hoc analysis for all PHS management. Qualifications High school diploma/GED required. Must possess at least one of the following license/certifications: RHIT, RHIA, CPC, CCS and a minimum of three (3) years experience in coding and/or auditing required. Audit experience preferred. Excellent written and verbal communication skills. Detail and results oriented. Ability to work independently and make independent decisions. Medical terminology, ICD-9, CPT-4 and HCPCS knowledge required. Proficient knowledge of Medicare, Medicaid, and other third‑party payer documentation, coding and billing regulations for assigned service lines. Excellent organizational and planning skills, including the ability to prioritize multiple tasks and perform them accurately and simultaneously. Computer skills, especially with Microsoft Word, PowerPoint, and Excel. Ability to use the internet and other resource applications for research purposes and to provide documentation that supports regulations quoted in audits. Strong written and verbal communication skills to communicate in clear, concise terms to management at all levels, including the ability to articulate complex regulatory information in layman’s terms. Professional presence characterized by honesty, integrity, and the ability to inspire and motivate others. Benefits All benefits‑eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short‑term and long‑term disability, group term life insurance and other optional voluntary benefits. Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in your personal well‑being by participating in wellness activities such as wellness challenges, webinars, preventive screening and more. Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. About Presbyterian Healthcare Services Presbyterian exists to improve the health of patients, members, and the communities we serve. We are a locally owned, not‑for‑profit healthcare system of nine hospitals, a statewide health plan and a growing multi‑specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees – including more than 1,600 providers and nearly 4,700 nurses. Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. AA/EOE/VET/DISABLED. PHS is a drug‑free and tobacco‑free employer with smoke‑free campuses. #J-18808-Ljbffr