SUMMARY
- Reports to PFS Manager responsible for audit and education. Performs coder and provider audits of ICD-10 codes, CPT codes and HCPCS codes. Prepares training materials and provides education as needed. Stays abreast of industry and payer changes pertaining to coding and documentation guidelines. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done.
- The core
- Success
- Factors include: Instill Trust and Value Differences
- Patient and
- Community
- Focus and
- Collaborate
- RESPONSIBILITIES: Audit professional ambulatory medical records for multispecialty provider organization to assure billed codes are accurately supported by the documentation.Possess knowledge of teaching physician regulations, including incident to, split shared and attestation requirements.Review diagnoses, procedures and modifiers assigned by coders, and record outcomes. Share completed audit results with Validation Team Leadership who will relay results to Coding Manager and/or Director so they can provide feedback to the individual coders, as needed.Review diagnoses and procedures assigned by providers and record outcomes. Shared completed audit results with Validation Team Leadership who will relay results to individual providers and provider leadership.Stay abreast of coding and documentation guidelines, compliance policies, annual coding updates, payer policies and industry changes. Utilize this knowledge in day to day workload.Identify coding/documentation trends that may pose a risk to Brown University Health or its revenue stream and report such trends to management team. Recommend improvements to documentation templates in Epic that will minimize compliance risk and facilitate accurate documentation for the providers. Assure documentation is defensible in the event of an external audit.Work with Practices/Clinics, Providers, Coding Team, Corporate Compliance, Risk Management, Contracting and Payers to help assure that all departments are consistently on the same page and able to provide accurate feedback to coders and providers.Abides by the Standards of Ethical Coding as set forth by the American Academy of Professional Coders and American Health Information Management Association. Performs other duties as assigned. MINIMUM
Qualifications
EDUCATIONuccessful completion of coding certification program (CPC).Understanding of the content of the medical record. Trained in medical terminology, medical science, anatomy and physiology. Ability to recognize and understand clinical documentation pertinent for coding. Good writing skills to communicate coding/documentation issues clearly. Computer literate; capable of researching websites to access regulatory requirements. Ability to navigate the patient electronic medical record.Excellent written and oral communication skills. Proficient in Microsoft Word, Excel and other computer applications.EXPERIENCE:Five years coding experience, preferably in a large, academic multispecialty organization. Past auditing experience or strong background in coding preferred.WORKING CONDITION AND PHYSICAL
Requirements
Normal office environment.INDEPENDENT ACTION:Performs independently within the department's policies and procedures. Refers specific complex problems to the supervisor when clarification of the departmental policies and procedures are required.SUPERVISORY RESPONSIBILITY: None Pay Range: $29.53-$48.72 EEO Statement: Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.
Location
- Corporate Headquarters - 15
- LaSalle
- Square
- Providence,
- Rhode
- Island 02903
- Work
- Type:
- M-F
- Days
- Work
- Shift:
- Day
- Daily
- Hours: 8 hours
- Driving
- Required: No As Rhode Island's largest health system and private employer, Brown University Health is the state's premier provider of health services and includes the only Level I Trauma Center for southeastern New England. Today, more than 20,000 people work at Brown University Health and bring their unique skills, experiences, and compassion to their jobs every day. Formed in 1994, Brown University Health is a not-for-profit health system based in Providence, RI comprising three teaching hospitals of
- The
- Warren
- Alpert
- Medical
- School of
- Brown
- University: Rhode Island Hospital and its Hasbro Children's; The Miriam Hospital; and Bradley Hospital, the nation’s first psychiatric hospital for children; Newport Hospital, Saint Anne's Hospital and Morton Hospital, community hospitals offering a broad range of health services; Gateway Healthcare, the state’s largest provider of community behavioral health care; and Brown Health Medical Group, the largest multi-specialty practice in Rhode Island. Brown University Health is an equal opportunity employer that values diversity of cultural background, race, gender, age, religion, identity, ability, and perspectives - we are actively committed to a diverse workforce that represents the patients and community that we serve. We are invested in creating a respectful, inclusive, and equitable environment that supports the holistic well-being of our employees and their families. Join us and help build a healthier future for our patients - and for yourself. Company Location Belonging and Engagement Nursing Our Mission
