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Posted: Tuesday, January 24, 2017 12:04 AM

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Company Name: Watson Clinic, LLP

Min Education: High School
Min Experience: 5-7
Job Function: Compliance/Corporate Compliance
Job Type: Full-Time
Salary: $0.00 - $0.00 (Yearly Salary)

Responsibilities:
• Conduct classroom and individual training/education of coding, reimbursement & payer guidelines to all providers and staff.
• Develop & assist with educational material for all providers and staff on CPT, ICD-10, HCPCS, and RAF scores. Along with federal and local healthcare regulations, reimbursement policies and procedures.
• Reviews Hospital and Clinic notes. Conduct Prospective and Retrospective reviews: review documentation for all services (including but not limited to; E&M, Surgical procedures, modifier usage, diagnosis code supporting medical necessity, labs and radiologic examinations.
• Review specific aberrances and any atypical billings. Exercise good judgment in decision-making regarding audit of those findings.
• Reviews all reimbursement tools for coding/policy additions, revisions and deletions (encounter tickets, forms, job aids and any other items as deemed necessary) and distributes to all providers and staff.
• Assist director with per specialty practice assessments: Identify potential risks to the organization; ensure compliance to policies & procedures, payer regulations and coding guidelines. Review all applicable templates and current reimbursement tools, analyze denied services and adherence to federal/local guidelines.
• Remains current with CMS/Federal guidelines (Federal register, transmittals, policies etc) Along with private payer guidelines.

Job Requirements
• Education: High School diploma or equivalent.
• Experience: Minimum 5 years medical coding/healthcare reimbursement experience.

Other Requirements: Certification by American Academy of Professional Coders (CPC) or equivalent organization and CRC (Certified Risk Coder) for a minimum of 5 years. CRC (Certified Risk Coder) must be obtain within six (6) months of employment. Must have advanced knowledge in medical terminology and anatomy. Must have advanced knowledge of insurance reimbursement, principles and practice. Conduct prospective & retrospective audits for both inpatient and outpatient physician/provider services. Experience with healthcare claims management systems. Must have the ability to plan, organize, direct & control a classroom/meeting environment. Must have knowledge of PC and Microsoft Office. Good analytical, written, and verbal communication skills.

Contact Person: Wendy Gonzalez
Email Address: wgonzalez2@watsonclinic.com
Phone: 8636807105
Apply URL: http://www.watsonclinic.com

• Location: Lakeland, Lakeland, Florida

• Post ID: 26475062 lakeland
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