HIS - Professional Coding Integrity Specialist (40 hrs/wk.)

1 month ago


Findlay, United States CareerBuilder Full time

PURPOSE OF THIS POSITION

The primary purpose of the Professional Coding Integrity Specialist (PCIS) is to review, enter and/or modify charges as appropriate, including review of clinical documentation to ensure charge is supported and/or to determine specific charge/modifier assignments, for designated clinical areas.

JOB DUTIES/RESPONSIBILITIES

Duty 1:

Review, enter and/or modify charge on encounters to ensure accurate and compliant and optimal charge capture in a time-sensitive manner for designated clinical service lines. Review clinical documentation to ensure charge is appropriately supported and/or to determine the assignment of the accurate charge, modifier, E&M levels, etc. Assign ICD-10 diagnosis codes as appropriate. Work exception accounts (e.g. canceled accounts, combined, unique modifier or charge rules requiring review, etc.) through review of clinical documentation and/or collaboration with appropriate resources, as needed, to resolve.

Duty 2:

Support resolution of claim-scrubber edits (Quadax) resulting from charges entered by the Revenue Integrity Validation team; collaborate with clinical areas, coding, PFS, etc. to support resolution of edits; trend, identify opportunities, and collaborate with RI Educator and/or Claims Resolution Specialist to avoid/reduce future edits. Support Condition 44 notifications (inpatient to observation status) process by properly modifying charges and calculating hours etc.

Duty 3:

Track and quantify revenue impact to organization as a result of charge corrections made, including impacts from modifications to processes.

Duty 4:

Identify opportunities related to clinical documentation and/or other system enhancements to support optimal and accurate charge processes; collaborate with CDI Specialist, Claims Resolution Specialist, Revenue Integrity Auditor, Revenue Integrity Educator, clinical area, and other areas to support resolution of issues.

Duty 5

. Demonstrate proficient knowledge of federal, state and third party charging guidelines of clinical areas supported by the Revenue Integrity Validation team to ensure optimal, accurate and compliant charging. Understand changes to applicable coding and billing regulations, including annual IPPS/OPPS revisions, by resourcing credible references (i.e. CMS website, Craneware, publications, professional contacts, reliable internet sources, seminars, etc.). Collaborate with clinical areas, Revenue Integrity Team, Coding Integrity Team and/or other impacted areas to support implementation of changes.

Duty 6:

Participates in system testing as a result of upgrades, changes, enhancements, new application implementations, etc. that may impact Revenue Integrity Validation processes.

Duty 7:

Regularly attends and actively participates in in-services, organizational and department meetings and continuing education programs as offered in order to remain current with organizational and industry changes and best practice. Communicate and disseminate information to other departments as applicable.

REQUIRED QUALIFICATIONS

An Associates degree in a related field including, but not limited to, health information, business or related clinical profession preferred or 1-2 years experience from which comparable knowledge and abilities have been acquired.

Coding certification (CCA or CPC) required or obtained with 9 months of hire date

Knowledge of medical terminology and anatomy and physiology required.

Knowledge of CPT/HCPCS/APC coding systems, appropriate use of applying modifiers, CPT Assistant, LCD/NCD and ICD-10 required.

Ability to research, review and interpret Federal, State and Local billing regulations required.

Familiarity with utilization of computers and commonly used applications, including Microsoft Office Suite, (Windows, Excel, Word, Outlook), electronic health record, internet required.

Ability to track and monitor data to identify trends pertaining to charge issues.

Excellent organizational, time management and problem-solving skills required; detail oriented and follow through.

Positive service-oriented interpersonal and communication (written and verbal) skills required.

PREFERRED QUALIFICATIONS

Other certifications applicable to primary clinical service line supported preferred.

Knowledge of regulatory compliance and reimbursement methodologies preferred.

Encoder experience preferred

Training and education skills preferred.

PHYSICAL DEMANDS

This position requires a full range of body motion with intermittent activities in walking, lifting, bending, squatting, climbing, kneeling, and twisting. The associate will be required to sit for five hours a day. The individual must be able to lift ten to twenty pounds and reach work above the shoulders. This position requires corrected vision and hearing in the normal range. The individual must have excellent eye-hand coordination and verbal communication skills to perform daily tasks.

#J-18808-Ljbffr



  • Findlay, United States EasternWoods Outpatient Center Full time

    PURPOSE OF THIS POSITION The purpose of a Mammography Technologist is to provide diagnostic radiographs initially and completely for the purposes of diagnosis and/or treatment of anatomical and physiologic disorders under the directions and supervision of a Radiologist while maintaining professional ethics. JOB DUTIES/RESPONSIBILITIES Duty 1: Demonstrates...


  • Findlay, United States ScrogginsGrear Full time

    Our busy medical practice has been providing the highest level of care for our patients since 1974. Our entire practice physicians and office staff are committed to maintaining rigorous standards of professional expertise and to offering the latest in technological advances. We are seeking an experienced HR Generalist with healthcare experience to assist our...


  • Findlay, United States ScrogginsGrear Full time

    Job DescriptionJob DescriptionOur busy medical practice has been providing the highest level of care for our patients since 1974. Our entire practice physicians and office staff are committed to maintaining rigorous standards of professional expertise and to offering the latest in technological advances. We are seeking an experienced HR Generalist with...

  • Medication Aide

    4 weeks ago


    Findlay, United States Birchaven Village Full time

    $2,500 Sign On Bonus PURPOSE OF THIS POSITION The primary purpose of this position is to support the licensed staff by giving direct resident care and performing Medication aide, well as, Nurse aide functions. This includes, but is not limited to administration of medication, as directed, as well as care for the personal needs and comfort of residents under...

  • Medication Aide

    2 weeks ago


    Findlay, United States Birchaven Village Full time

    $2,500 Sign On Bonus PURPOSE OF THIS POSITION The primary purpose of this position is to support the licensed staff by giving direct resident care and performing Medication aide, well as, Nurse aide functions. This includes, but is not limited to administration of medication, as directed, as well as care for the personal needs and comfort of residents under...

  • Hand Assembly

    1 month ago


    Findlay, United States Partitions Plus Full time

    Job DescriptionJob DescriptionJob DescriptionCome join our growing team at Partitions Plus located in Findlay, OH. We manufacture corrugated partitions (internal dunnage) in our 80,000 square foot facility. We are looking to add hard-working and dedicated production workers to our team to allow us to best serve our customers!Hours: 1st SHIFT Monday through...


  • Findlay, United States Summit Recruiting Group LLC Full time

    Pediatric Hospitalist Opportunity Findlay, OH Responsibilities: - Manage Level IIB Special Care Nursery- Emergency Department consults, limited outpatient medical consults- Newborn care, attendance at high-risk deliveries, inpatient pediatric care- Average of 1,000 deliveries/year- Manage infants born at 32 weeks and above, CPAP, Surfactant, and ventilator...

  • DevSecOps Engineer

    2 weeks ago


    Findlay, United States JobRialto Full time

    Primary Skills: Ansible, Jenkins, Azure, Selenium, SAP Description: The DevSecOps Engineer serves as the cornerstone of our DevOps team, ensuring the seamless integration and operational health of our development platforms. This role is pivotal in fostering the maturity of our Continuous Integration/Continuous Delivery (CI/CD) platform and advancing our...


  • Findlay, United States The Armes Family Cancer Care Center Full time

    PURPOSE OF THIS POSITION  The Radiation Therapy Therapist is responsible for the administration of radiation therapy services and monitors patient’s reactions. JOB DUTIES/RESPONSIBILITIES Duty 1: The Radiation Therapist schedules patients in an efficient manner to accommodate patients, physicians and staffing schedules. Duty 2: The Radiation Therapist...


  • Findlay, United States The Armes Family Cancer Care Center Full time

    PURPOSE OF THIS POSITION  The Radiation Therapy Therapist is responsible for the administration of radiation therapy services and monitors patient’s reactions. JOB DUTIES/RESPONSIBILITIES Duty 1: The Radiation Therapist schedules patients in an efficient manner to accommodate patients, physicians and staffing schedules. Duty 2: The Radiation Therapist...


  • Findlay, United States AB Staffing Solutions, LLC Full time

    CRNA - Findlay, OH 45840 Are you ready to explore new places while building your resume? At AB Staffing, we specialize in placing Advanced Practice providers in facilities throughout the United States. We offer travel assignments starting at 3 months with an opportunity to extend your contract or choose a new location to broaden your horizons. One of our...

  • 3rd Shift

    1 month ago


    Findlay, United States Partitions Plus Full time

    Job DescriptionJob Description3rd Shift Production Associate - Come join our growing team at Partitions Plus, a locally owned and operated manufacturing company located in Findlay, OH. We manufacture corrugated partitions (internal dunnage) in our 80,000 square foot facility. We are looking to add hard-working and dedicated production workers to our team to...


  • Findlay, United States RecruitWell Full time

    Northwest Ohio CRNA Opening Clinical Role: Seeking a Board Certified or Board Eligible CRNA Cardiac experience - Preferred Permanent position opportunity Option to practice at Findlay Hospital, Bluffton Hospital, and Findlay Surgery Center Care team model Work in a mentorship and collegial practice environment with a practice team of 7 full-time...

  • Res Care Float Nurse

    1 month ago


    Findlay, United States Birchaven Village Full time

    $2,500 Sign On Bonus - LPN $5,000 Sign On Bonus - RN PURPOSE OF THE POSITION The primary purpose of this position is to coordinate total nursing care for residents. Participates in resident and family teaching and provides leadership by working cooperatively in maintaining standards for professional nursing practice in a clinical setting  REQUIRED...

  • Res Care Nurse C/D

    4 days ago


    Findlay, United States Birchaven Village Full time

    $5000 Sign On Bonus for RN candidates! $2500 Sign On Bonus for LPN candidates!  PURPOSE OF THE POSITION The primary purpose of this position is to coordinate total nursing care for residents. Participates in resident and family teaching and provides leadership by working cooperatively in maintaining standards for professional nursing practice in a clinical...

  • Res Care Nurse

    5 days ago


    Findlay, United States Birchaven Village Full time

    $5,000 Sign On Bonus for RN Candidates! $2,500 Sign On Bonus for LPN Candidates! PURPOSE OF THE POSITION The primary purpose of this position is to coordinate total nursing care for residents. Participates in resident and family teaching and provides leadership by working cooperatively in maintaining standards for professional nursing practice in a clinical...

  • PRN LPN

    2 weeks ago


    Findlay, United States Everside Health Full time

    ABOUT THE JOB The LPN works with a concierge physician to provide healthcare services for corporate clients to ensure excellent care and experience for our patients. Everside Health nurses are responsible for front and back-office duties, including assessing patients, informing the physician of changes and assuring Everside Health physicians have the...


  • Findlay, United States Birchaven Village Full time

    RN- $5,000 Sign-on Bonus LPN-$2,500 Sign-on Bonus This position is the Baylor program. Associates are paid full-time at 36 hours but will be scheduled 24 hours each weekend. PURPOSE OF THE POSITION The primary purpose of this position is to coordinate total nursing care for residents. Participates in resident and family teaching and provides leadership by...


  • Findlay, United States AB Staffing Full time

    Psychiatrist - Findlay, OH 45840 Are you ready to explore new places while building your resume? At AB Staffing, we specialize in placing Physicians at VA hospitals, on Native American Indian Reservations and in hospitals throughout the United States. Our travel assignments range from six (6) months to one year, and can be added onto another assignment or...


  • Findlay, United States AB Staffing Full time

    Psychiatrist - Findlay, OH 45840 Are you ready to explore new places while building your resume? At AB Staffing, we specialize in placing Physicians at VA hospitals, on Native American Indian Reservations and in hospitals throughout the United States. Our travel assignments range from six (6) months to one year, and can be added onto another assignment or...