Medical Coder Compliance Spec

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Summary

Perform coding quality audits on outpatient records to assure appropriateness, accuracy, and compliance for CPT/HCPCs, ICD-10-CM code assignments, and modifier assignment in accordance with Center of Medicare and Medicaid Service (CMS) Guidelines, AMA and AHA Official ICD-10-CM Coding Guidelines. Provide ongoing feedback to managers and coders. Develop and implement educational programs regarding elements of the coding compliance program and act as a subject matter expert for the outpatient coding department.

What You'll Do

OPERATIONS

• Perform pre and/or post bill secondary chart review to validate modifier selection, E&M, procedural, and diagnosis coding in accordance with established coding guidelines
• Provide workflow and coding training to new hires
• Continuously provide feedback to coding staff to improve code selections that accurately describe the procedures and services performed by physicians in accordance to NCCI, AMA/CPT & ICD 10- guidelines
• Review and Dissect coding clinics, yearly AMA guidelines, ICD-10-CM and NCCI to prepare education sessions to outpatient coders.
• Develop and coordinate educational and training programs regarding elements of the Coding Compliance Program, such as appropriate documentation, accurate coding, and coding trends found during chart reviews.
• Respond to complex internal and external customer inquiries in relation to Mid-Service processes, documentation, and coding compliance standards.
• Participate in process improvement initiatives by use of technology
• Revise and/or write Policies & Procedures related to Revenue Cycle Mid-Service
• Assist with coding in the event of an unplanned emergency
• Demonstrate initiative by the continuous expansion of knowledge and skills
• Participate in department/unit activities including, but not limited to, staff meetings and in-services
• Perform other duties as assigned to maintain the efficiency of the department
• Protect the confidentiality of primary and secondary health records and the information therein as mandated by law, professional standards, and Health System policies

CUSTOMER SERVICE

• Demonstrates excellent customer service skills in working with Revenue Cycle staff, clinicians, and other UHMS staff. Model, support and reinforce a culture of service excellence

Mission Statement

Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally.  Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Skills You Have

• Extensive CPT/ ICD-10-CM coding knowledge with a strong understanding of the AMA, AHA and NCCI Official Coding Guidelines and how to apply them.
• Ability to leverage technology for process improvement.
• Analyze guidelines to provide in-depth education to staff.
• Excellent communication skills to enable effective outcomes with the Coding/MCCS team.
• Write appropriate queries to the clinical care team in accordance with the AHIMA Query Policy.
• Attention to detail with thoroughness and accuracy when accomplishing a task.
• Participate as an active member of Lean Thinking in daily work initiatives

Required Qualifications*

• Associate's Degree in Healthcare related field
• Registered Health Information Technologist or Administrator (RHIT/RHIA),CPMA,CCS or CPC.
• Three years' experience coding or auditing CPT, ICD-10-CM, and modifier assignment  
• Extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing.
• One-Three years of experience using 3M 360 CAC and/or other encoders
• Excellent verbal and written communication skills, analytical thinking, and problem-solving skills with attention to detail are required.
• Proficiency in organizational skills and planning with an ability to juggle multiple priorities in a fast-changing environment
• Experience in developing and providing education to coders and physicians
• Ability to work independently, be self-motivated, and the ability to adapt to the changing healthcare environment.

Desired Qualifications*

• Experience and Knowledge of University information systems, policies, and procedures

Additional Information
Supervision Received

General supervision is received from the Coding Quality and Education Manager

Background Screening

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings.  Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

Application Deadline

Job openings are posted for a minimum of seven calendar days.  The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.

U-M EEO/AA Statement

The University of Michigan is an equal opportunity/affirmative action employer.