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Medical Record Coding Compliance Specialist

2 months ago

Bristol, Connecticut, United States BRISTOL HOSPITAL GROUP Full time
Job Summary

Bristol Hospital Group is seeking a highly skilled Medical Record Coding Compliance Specialist to join our team. As a key member of our healthcare team, you will be responsible for ensuring the accuracy and compliance of medical records and billing documentation.

Key Responsibilities
  • Perform ongoing chart audits of new and established provider medical records and billing documentation, adhering to established timelines.
  • Act as the primary point of contact for payer audit requests, ensuring timely and accurate responses.
  • Maintain current knowledge of coding and documentation requirements, staying up-to-date with industry developments and regulatory changes.
  • Provide expert guidance on HIPAA and Medicare guidelines, ensuring compliance across the organization.
  • Develop and implement ICD-10 training and education programs for physicians, coders, billers, and office staff, promoting a culture of excellence and compliance.
  • Coordinate the dissemination and education of providers and staff on chart audit findings, maintaining accurate and retrievable records using Intelicode software.
  • Prepare and submit quarterly reports to the AVP BHMG and providers, highlighting key findings and recommendations.
  • Develop and maintain currency of coding and documentation manuals, ensuring accuracy and relevance.
  • Design and implement quarterly auditing monitoring compliance activities, identifying areas for improvement and implementing corrective actions.
  • Review and audit 20 charts per provider, utilizing EMR software to ensure accuracy and efficiency.
  • Benchmark findings against national averages, providing actionable insights for improvement.
  • Provide audit reports to the AVP and Billing Manager within 48 hours of chart review, ensuring timely and accurate communication.
  • Participate in departmental in-services, identifying topics for presentation and taking responsibility for delivering engaging and informative content.
  • Seek out opportunities for learning and skill development, staying ahead of industry trends and best practices.
  • Provide backup support for surgical coding and charge entry, ensuring seamless operations.
Requirements
  • AS degree with three years of health experience, or BS degree preferred.
  • Must successfully complete a coding certificate program.
  • Certified Professional Coder (CPC) certification is required, with Certified Professional Medical Auditor (CPMA) certification preferred.
  • Additional auditing experience is strongly preferred.