Find what you're looking for in your career, at PacMed as a Coding and Audit Manager in Seattle, WA\.
This is a full time position \(40 hours per week\) in our USFHP department and is eligible for benefits\.
We are seeking a Coding and Audit Manager to be responsible for achieving and maintaining provider coding accuracy and completeness at the levels required by the yearly Corporate Compliance Work Plan\. The Coding and Audit Manager will work directly and intensively with new providers to educate and monitor their compliance to coding and reimbursement standards and to develop work plans for them to meet requirements, as well as serve in a consultant capacity to the Compliance Manager and Compliance Officer regarding potential areas of improvement for the company in meeting the Compliance Plan, and to the CMO on potential improvements in recruiting, coding and auditing of E&M services, and procedures\.
In this position you will:
- Provide education to contracted physicians/facilities, coding and PMC CBS staff\.
- Validate reimbursement to third parties for service through accurate CPT and ICD\-9 coding; and ensure appropriate medical record documentation supports billed charges\.
- Review documentation to ensure all appropriate signs, symptoms, chronic and acute conditions are supported and reported\.
- Perform review and application of HCC codes when applicable\.
- Develop and perform integrity risk assessments and audits based upon process and documentation standards\.
- Routinely complete coding and documentation audits based on compliance issues, OIG and DHA work plan and intuition\.
- Act as a resource to USFHP staff as well as contracted physicians and facilities to answer coding and/or reimbursement questions\.
- Review reimbursement denials and appeals from third parties associated with inappropriate diagnosis or procedure coding\.
- Have demonstrated expertise in current multi\-specialty CPT, ICD\-9, and HCPC coding principles and practices\.
Required qualifications for this position include:
- Hold and maintain CPC, CCS\-P or CMC coding certification\.
- A minimum of 5 years health care experience in a physician group practice or other ambulatory care setting\.
- A minimum of 5 years of coding experience for a multi\-specialty group\.
- A minimum of 2 years of experience conducting provider education and audits\.
- Hold or obtain and maintain ACS E/M or CEMA or CPMA CRC auditing certification within 6 \(six\) months of hire\.
- HCC hierarchal coding experience\.
Preferred qualifications for this position include:
- Bachelor's degree or equivalent experience in health care related field\.
Pacific Medical Center Beacon Hill Clinic:
The patient population we care for is culturally and clinically diverse, creating a stimulating and rewarding workplace\. Our strong team environment and mission allow us to provide friendly services that focus on the highest quality patient care\. PacMed's compensation and competitive benefits package will support and enhance a lifelong career\.
The Beacon Hill clinic is conveniently located near the intersection of I\-5 and I\-90 in central Seattle\. Beacon Hill offers both primary care—including Family Medicine, Internal Medicine, Obstetrics and Geriatrics—and more than a dozen different areas of specialty care\. Home to The Diagnostic and Wellness Center for Women, Beacon Hill offers digital mammography, breast ultrasound, MRI and biopsy as well as therapeutic massage\. Other services offered at Beacon Hill include an anticoagulation clinic, infusion therapy, x\-ray, onsite laboratory and pharmacy\. Interpreter services are also available for our patients\.
Seattle is the Pacific Northwest's largest urban center \(metro population 3\.25 million\), with world\-class arts and entertainment, a robust economy and an outstanding school system\. The city hugs magnificent Puget Sound and offers magnificent mountain views to the north, east and south\. Seattleites are famously fond of the outdoors, fresh seafood and good coffee\.
The Beacon Hill clinic is part of Pacific Medical Centers' expanding network of outpatient clinics providing primary and specialty care to the greater Seattle area and employing more than 150 providers representing most medical specialties\. Pacific Medical Centers is affiliated with Providence Health & Services, which operates 28 exceptional not\-for\-profit hospitals and more than 350 clinics across the West\. With hundreds of physician and advanced practice provider opportunities in virtually all specialties at any given time, Pacific Medical Centers and Providence offer diverse locations, lifestyles and practice models\. Find what you are looking for in your next practice opportunity with Pacific Medical Centers\! Learn more at www\.pacmed\.org/providerjobs\.
We offer a full comprehensive range of benefits — see our website for details —
Our mission is to provide respectful, high\-quality, patient\-focused healthcare to each person and to the communities we serve\.
Pacific Medical Centers \(PacMed\) is a private, not‐for‐profit, multi‐specialty healthcare network in the Puget Sound region\. Our 9 convenient locations are staffed by a comprehensive network of more than 150 primary and specialty care professionals who are committed to providing the highest\-quality medical care and to developing a compassionate, long\-term relationship with each patient we serve\. Our personalized, patient\-centric system empowers and provides patientswith freedom and choices to partner in their care\. We provide immediate access to cutting\-edge technology, first\-class facilities and board\-certified specialists, many of whom have been listed as among "Seattle's Best Doctors\.", PacMed is committed to providing physical activity and wellness opportunities for our employees\. We have been honored as a 2014 Gold Level Recipient of the American Heart Association's Fit\-Friendly Worksites Recognition program\.
Job Category: Coding
Req ID: 145277