Business: Boys Town National Research Hospital Job Summary: In a career as a Coding Reviewer & Educator, you join us in providing life-changing care to patients from across the region. In this role, you will provide coding support to multi-specialty physicians, mid-level providers, support staff and administration. Monitor coding and billing activities to ensure activities performed are following applicable federal and state statutes/regulations. Provide education to departments and staff to ensure accurate coding, billing, and to improve documentation to support all aspects of coding and billing, as a result of scheduled and impromptu physician and coder reviews Schedule: Full Time, 8:00 AM-5:00 PM, Monday-Friday Responsibilities:
Reviews provider documentation (i.e., EMR, operative notes, etc.) coding submissions performed by the Medical Coding Group, including and resulting professional coding and billing from various departments and specialties within BTNRH, per the standards set forth in the Boys Town National Research Hospital (BTNRH) Coding Compliance Plan, reporting on the accuracy of procedure coding, E&M coding, ICD-10 coding and billing, to ensure legal regulations and procedural policies are being followed.
Through various reporting opportunities, identifies inaccurate coding and/or billing services; prepares reports of findings, and meets with coders, providers, and medical office staff to provide education and training on accurate coding practices
Assists in training personnel in correct documentation processes and coding guidelines.
Applies knowledge of /ICD-10-CM inpatient and outpatient coding guidelines and CPT format, guidelines, and notes to locate the correct codes and sequence them correctly. Clarifies conflicting, ambiguous, or nonspecific information, querying and consulting the appropriate clinician to ensure sufficient documentation and accurate codes being billed for physician professional services.
Oversees and coordinates on-going projects (i.e., Documentation or guideline changes, new services or procedures) that are within the scope of this position.
Performs charge reviews as requested through the patient concern/dispute process by comparing the charges against all necessary clinical documentation, looking for discrepancies and communicates findings to the Customer Service Manager.
Provides expertise to other Patient Financial Services members in order to work through denials specific to coding, in order to reach resolution of those denials.
Reviews account findings with representatives of 3rd party agencies, substantiating the BTNRH charge and/or documentation. Also develops appropriate suggested action plans and communicates overall findings to the Director of PFS.
Responsible for monitoring statistical data based on review findings and concurrent reviews for trending purposes and summaries for Administration.
Required Qualifications:
High school diploma or equivalent
Associate or Bachelor degree in business, healthcare or related field, preferred, with a minimum of 5 years experience in compliance, medical auditing, utilization review, coding or other related healthcare experience, required
CPC required and CPMA required within 6 month of hire,
Must have experience with software applications as they apply to the computerized patient record and billing system. Consideration will be given to persons with an equivalent combination of education and experience from which comparable knowledge can be acquired.
About Boys Town: Boys Town has been changing the way America cares for children and families since 1917. With over a century of service, our employees have helped us grow from a small boardinghouse in downtown Omaha, Nebraska, into one of the largest national child and family care organizations in the country. With the addition of Boys Town National Research Hospital in 1977, our services branched out into the health care and research fields, offering even more career opportunities to those looking to make a real difference. Our employees are our #1 supporters when it comes to achieving Boys Towns mission, which is why we are proud of their commitment to making the world a better place for children, families, patients, and communities. Unique perks to Boys Town employees and their families include free visits to Boys Town physicians and free prescriptions under the Boys Town Medical Plan, tuition assistance, parenting resources from our experts and professional development opportunities within the organization, just to name a few. Working at Boys Town is more than just a job, it is a way of life. Date Posted: January 27th, 2021 Boys Town National Research Hospital is a tobacco free campus. This advertisement describes the general nature of work to be performed and does not include an exhaustive list of all duties, skills, or abilities required. Boys Town is an equal employment opportunity employer and participates in the E-Verify program. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status. To request a disability-related accommodation in the application process, contact us at 1-877-639-6003.
