Coder - PPSC Billing Center Admin
SMG - Boston/Brighton Area - Revenue Mgmt.
PPSC Billing Center Admin
Associate's degree is preferred.
Steward Health Care System LLC ("Steward") is a fully integrated, physician-led national health care services organization committed to providing the highest quality of care in the most cost-efficient manner in the communities where our patients live. Steward - the largest privately held health care company in the U.S. - owns and operates 35 community hospitals across nine states, serves over 1,000 distinct communities and employs approximately 40,000 health care professionals. In addition to our hospitals, the Steward provider network includes 4,800 providers, 25 urgent care centers, 87 preferred skilled nursing facilities, substantial behavioral health offerings, over 7,300 hospital beds under management, and approximately 1.5 million full risk covered lives through the company's managed care and health insurance services.
Steward Medical Group (SMG), Inc. is Steward's multi-specialty group practice with over 4,500 employees including over 1,800 physicians and advanced practitioners. SMG operates approximately 450 practice locations throughout Massachusetts, Southern New Hampshire, Rhode Island, New Jersey, Pennsylvania, Ohio, Florida, Utah, Arizona, Texas, Louisiana and Arkansas, and provides more than 4 million patient encounters per year.
Assign ICD-10, CPT and HCPCS codes to all relevant physician claims. Ensure that E&M levels are accurate and documentation supports appropriate level assigned and medical necessity of service. Ensure all demographic and insurance data is accurate based upon information contained within the documentation.
The department is looking for a coder with experience in internal medicine, cardiology or OB/GYN experience preferred. Flexible hours including day and evening hours are available.
* Communicate with providers and practices to ensure all encounter forms are current.
* Disseminate information regarding new codes and/or coding policies either by payer or through regulations.
* Create and maintain department processes and controls according to Professional Coding Standards, CMS Standards, HIPAA, OIG, and the State of Massachusetts as well as national payor coding guidelines as they pertain to professional coding and reimbursement.
* Educate providers and clinical staff through review and education of documentation.
* Champion coding compliance, through Revenue Cycle team utilization of recognized professional references, and adherence to established coding convention and regulation.
* Participate in departmental and physician network performance improvement initiatives.
* Safeguards medical records and preserves the confidentiality of personal health information through the observance of physician network policies pertinent to the release of medical record information, record retention, and HIPAA privacy and security.
* Other duties as assigned.
* Associate's degree in Health Information Technology or related business degree or equivalent amount of education and experience.
* Current certification as a CPC or CCS-P from AAPC or AHIMA
* Experienced specialty coding in orthopedics.
* Computer literacy of medical information system, records management software, encoders.
* Demonstrated coding (ICD-10 CM and CPT) expertise.
* Understanding of third party reimbursement rules and regulations.
* Experience with encoder software.
* Ability to work independently with minimal supervision.
* Professional interpersonal and organizational skills.
* Attentive to detail and organization.
Job Status: Full Time
Job Reference #: 54374