Physician Billing Compliance Specialist

Responsibilities

• Systematically monitor, review and analyze patient medical records to determine all appropriate diagnosis and procedures performed.
• Provide feedback and education to providers.
• Conduct chart audits to ensure providers are in compliance with coding and regulatory guidelines.
• Provide feedback to director regarding audit results.
• Maintain thorough knowledge of coding and documentation requirements outlined by CPT, ICD-9-CM and CHOP Compliance for all physician services performed.
• Develop and provide coding and documentation seminars for the providers.
• Inform providers/directors each year of coding changes for the following year.
• Work with Epic support to ensure that new codes are entered into the system in a timely manner.
• Meet with members of CHOP’s Coding and Compliance Department to ensure department policies are line with the hospital.
• Provide coding training to new physicians hired, annually, and as requested by the division.

Qualifications

• High School Diploma / GED Required
• Bachelor's Degree Preferred
• At least three (3) years experience in related field Required
• Physician billing Preferred
• Teaching physician guidelines Preferred

Skills And Abilities

• Knowledge of Microsoft Office Suite including PowerPoint, Excel and Access; internet research skills.
• Excellent communication and interpersonal skills required.
• Excellent organizational skills.
• Analytical abilities.
• Excellent written and oral presentation skills.
• Eagerness to learn new areas and work with little supervision.
• Good judgment.
• Ability to work with confidential materials and to juggle multiple tasks.

Education

• High School Diploma / GED Required
• Bachelor's Degree Preferred

Relevant Certifications

• Registered Health Information Administrator (RHIA) - American Health Information Management Association - upon hire - Required
• Registered Health Information Technician (RHIT) - American Health Information Management Association - upon hire - Required
• Certified Coding Specialist (CCS) - American Health Information Management Association or National Association for Health Professionals - upon hire - Required
• Certified Coding Specialist-Physician-Based (CCS-P) - American Health Information Management Association - upon hire - Required
• Certified Professional Coder (CPC) - American Academy of Professional Coders - upon hire - Required