Profee Clinical Data Quality Admin (CDQA) / Coding Auditor / Coding Educator for Virtua Medical Group - CPC (Remote)
Profee Clinical Data Quality Admin (CDQA) / Coding Auditor / Coding Educator for Virtua Medical Group - CPC (Remote)
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1 Vacancy
Job Description
At Virtua Health we exist for one reason to better serve you. That means being here for you in all the moments that matter striving each day to connect you to the care you need. Whether thats wellness and prevention experienced specialists life-changing care or something in-between we are your partner in health devoted to building a healthier community.
If you live or work in South Jersey exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14000 colleagues including over 2850 skilled and compassionate doctors physician assistants and nurse practitioners equipped with the latest technologies treatments and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report weve received multiple awards for quality safety and outstanding work environment.
In addition to five hospitals seven emergency departments seven urgent care centers and more than 280 otherlocations were committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through ourEat Well food access program telehealth home health rehabilitation mobile screenings paramedic programs and convenient online scheduling. Were also affiliated with Penn Medicine for cancer and neurosciences and the Childrens Hospital of Philadelphia for pediatrics.
Location:
100% RemoteCurrently Virtua welcomes candidates for 100% remote positions from: AZ CT DE FL GA ID KY MD MO NC NH NJ NY PA SC TN TX VA WI WV only.Employment Type:
EmployeeEmployment Classification:
RegularTime Type:
Full timeWork Shift:
1st Shift (United States of America)Total Weekly Hours:
40Additional Locations:
Job Information:
*The shift schedule is anywhere between 7am- 7pm depending on meetings with clinicians.
Summary:
Responsible for coding quality and audits education and training etc. for ICD-10-CM CPT and HCPCS codes for Virtua Medical Group and Pro-Fee coding department. Responsible for developing implementing and maintaining compliance plan for provider coding and abstracting.
Responsible for coding quality and audits education and training.
Responsible for developing implementing and maintaining compliance plan forVMG coding and abstracting.
Participates in system administration maintenance duties for coding and abstracting software.
Position Responsibilities:
Audits
Designs audit tools to monitor coding and abstracting quality and compliance; performs audits; provides timely feedback to staff and providers; makes recommendations for improvement.
Performs special audits to facilitate quality improvements and compliance (External Coding Audit Response: Conducts exit interviews with external auditors prepares rebuttals and appeals take appropriate action with responses (including correcting data and educating coders and providers).
Conductsmeetings to discuss outcomes reviews reports works with physicians to provide appropriate clinical documentation to ensure compliant assignment of codes.
Responds to daily questions from coders and providers regarding correct application of coding guidelines to individual accounts.
Accounts Receivable
Assists with monitoring of Discharge Not Final Billed reports troubleshooting resolving complex problems with individual accounts in order to facilitate appropriate reductions in A/R and accounts held for coding.
Codes charts when urgently needed to facilitate A/R goals.
Works closely with all areas to provide efficiencies in operational coding workflow adjustment in workflow queues etc.
Patient Accounting Resolution
Works closely with Patient Accounting vendorto resolve coding and reimbursement issues serves as an escalation point and answers questions regarding coding requirements.
Policies and Procedures
Develops policies and procedures on coding data abstraction and Corporate Compliance.
Documents and enforces policies and procedures for staff and providersand provides feedback to appropriate supervisors and/or staff.
Recommends changes to policies procedures charge master and documentation requirements to insure appropriate reimbursement.
Monitors and reports on productivity and quality standards.
Coding abstracting and state data system maintenance
Maintains and updates systems to collect accurate data for billing and state data collection as well as hospital statistical requirements.
Identifies and resolves problems with the assistance of IS and vendor counterparts.
Manages downtime and puts back up plans into place.
Facilitates timely completion of state reporting by monitoring reports and taking action to resolve accounts in question.
Position Qualifications Required / Experience Required:
3 years Pro-Fee auditing and education experience required
General Pro-Fee coding experience required multi-specialty preferred (cardiac obstetrics orthopedics medical-surgical etc.)
Knowledge of PC database applications Microsoft Office spreadsheet design encoder required.
Knowledge of ICD-9 CPT-4 DRGs APCs and CMI required.
Able to develop and present education presentations required.
Required Education:
Bachelor or Associates Degree in HIM or Coding Certificate Program or equivalent experience leading to appropriate certification.
Training/Certifications/Licensure:
Certification as CPC by AAPC required CPMA preferred
For more benefits information click here.
Employment Type
Full-Time
