100,000's of Government Jobs

Search Government Jobs

Job Field: Legal Jobs
Location: WENATCHEE, WA
Salary: $-
Job Type: Part Time

JOB SUMMARY:

---

</tr>
            </table>
            <table border="0" bgColor="#F5F5F5" cellpadding="5" cellspacing="0" style="border-collapse: collapse" width="100%">
            <tr>
               <td align="left"><font style="font-size: 100%;">Compliance and Documentation Specialist<BR>Department: Compliance<BR>Schedule: Full Time<BR>Shift: Day<BR>Hours: 8<BR>Job Details: <BR>* <BR>There are currently 5 Specialist positions available.<BR><BR><BR>OVERALL PURPOSE OF POSITION:<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><BR><BR>Facilitates appropriateness of revenue while maintaining compliance standards for WVMC through implementation and completion of prospective and retrospective auditing and monitoring. Serves as an expert resource for accurate coding and billing practices according to industry standards and Medicare guidelines. <BR>JOB FUNCTIONS<BR><BR>1. Performs documentation audits, prepares practitioner summaries and conducts follow<BR> up education.<BR>* Initial, Annual, Focused, Managed Care<BR>* Practitioner, facility, support staff<BR><BR>2. Prepares, updates and monitors practitioner profiles.<BR>* Dept, WVMC, national by specialty<BR>* CPT / HCPCS / ICD<BR>* Severity Rating analysis<BR>* Medical necessity<BR>* Documentation regulations<BR>* Outlier status / monitoring reports<BR><BR>3. Conducts new practitioner orientation.<BR>o   Specialty specific documentation and coding education<BR>o   Introduction to compliance responsibilities<BR>o   Assists in setting up procedures and processes for new procedures<BR><BR>4. Performs ?deep dive? chart reviews to validate reported diagnoses and uncover unreported diagnoses. Facilitates updated patient evaluations with clinical staff. Facilitates corrections to patient?s diagnostic profile with payer.<BR><BR>5. Serves as an expert resource for practitioners, managers and staff in patient specific documentation and coding. <BR><BR>6. Facilitates external audit process and assists in analysis and review of RAC, MIC, MAC, ZPIC, RADV and other payer / government audits. <BR><BR>7. Supports managers in department license and survey inspections such as Rural Health, ASC, and facility reviews. <BR><BR>8. Provides compliance support for Kaizan and RIPWs in assigned departments.<BR><BR>9. Provides practitioner and staff education and updates as regulatory and coding issues evolve (i.e. ICD-10 implementation). Monitors state and federal websites for news/regulations/policy changes enacted or proposed. <BR><BR>10. Assists EPIC staff in building regulatory compliance into EPIC processes and procedures.<BR><BR>NOTE:This list of job functions is not intended to be all inclusive and may be expanded to include other functions that may be deemed necessary.<BR>          <BR>QUALIFICATIONS<BR><BR>Education/ Experience<BR>Required:<BR>Applicant must have either clinical experience or coding experience. <BR>3 - 5 years experience in one or more of the following:<BR>?    Medical coder<BR>?    Clinical work as MA, LPN, RN<BR>?    Transcription(assuming education in anatomy/physiology)<BR>?    Insurance Appeals<BR>?    EPIC education / experience<BR><BR>Preferred:<BR>?    Understanding of regulatory guidelines and their application to technical coding.<BR>?    Clinical education and/or experience. <BR>?    Certified Coder<BR>?    Certified Compliance Specialist<BR><BR>Licenses/certifications<BR>Requires a valid driver?s license                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     </font></td>
            </tr>
            </table>
            <table border="0" bgColor="#F5F5F5" cellpadding="0" cellspacing="0" style="border-collapse: collapse" width="100%">
            <tr>