Responsible for providing consulting services to clients (i.e., physicians, physician groups, billing companies, hospitals, health systems, health care attorneys, and other health care entities) including coding/documentation audits, billing audits, compliance audits, general and targeted educational sessions, expert advice on coding, documentation, and billing topics, operational assessments and other engagements as assigned.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Provides consulting services with client in accordance with their contractual agreement (onsite and remote).
Consistently follows the Consulting Workflow for all projects (audits and education)
Performs comprehensive documentation, coding, billing and/or compliance audits in accordance with client contract.
Create accurate well written reports summarizing audit findings and recommendations which include clear explanation of errors and references for authoritative guidance supporting recommendations when applicable.
Contacting client for scheduling of all necessary meetings (kickoff, updates, summation, and education)
Conduct the project kickoff call, complete the project plan document, and any required EMR access forms.
Present audit findings and recommendations in person or by phone
Customize training material for client specific needs using all Microsoft applications and any other necessary tools.
Deliver onsite or remote educational sessions
Conducts and participates in webinar trainings, conference calls, creation of documents and materials for clients
Other consulting projects as assigned (ex. CDM reviews, workflow assessments, denials management evaluations, etc.)
Maintains an accurate record of time spent on all assignments using Clockify task tracking tool and follow department guidelines for appropriate use. (client and non-client work)
Assist in creating and updating coding reference manuals and presentations as needed
Communicates with Management regarding client concerns, issues or assistance as needed.
Monitors government regulations & programs and presents information to the company and clients
Prepares industry related articles for publication when requested
Strives to achieve maximum exposure and strong public image of Revenue Cycle Coding Strategies to all industry stakeholders
Works on ensuring a strong, positive relationship between all company divisions
Ensures compliance with company Policies and Procedures, State, and Federal Regulations
Maintains confidentially of all information related to patients, medical staff, finances and all other company and client information.
Submits accurate invoices and expense reports timely to the appropriate department following company policies.
Adheres to all RCCS policies and procedures.
Additional duties as assigned.
EDUCATION AND/OR EXPERIENCE:
Bachelor’s degree preferred but not required.
Coding certification(s) required by one or more of the following bodies: AHIMA, RCCB, AAPC.
Willingness to obtain additional industry specific certifications within one year of employment.
Minimum three (3) years of experience as a consultant, auditor/educator, or compliance professional in healthcare.
QUALIFICATIONS:
Knowledge of coding, documentation, and reimbursement
Knowledge of organization policies and procedures
Knowledge of health care administration principles
Knowledge of business office procedures as they relate to the healthcare industry
Skill in exercising initiative, judgment, discretion, and decision-making to achieve objectives.
Skill in identifying and resolving problems
Ability to communicate effectively and professionally with all levels of staffing in health care provider organizations and business-related organizations.
Ability to establish and maintain effective professional working relationships with all employees and clients
Knowledge of CPT-4, diagnosis and HCPCS coding.
Highly detail-oriented individual with outstanding analytical and writing skills, and ability to communicate professionally with clients and employees of RCCS.
Must be competent and comfortable with MS Word, Excel, and PowerPoint. Experience working in MS Access is preferred.
SUPERVISORY RESPONSIBILITIES:
None
PHYSICAL DEMANDS:
The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position requires full range of body motion including manual and finger dexterity and eye-hand coordination. The position additionally requires standing/sitting for extensive periods of time. Occasional lifting and carrying items weighing up to forty (40) pounds may be required. Requires corrected vision and hearing to normal range.
WORK ENVIRONMENT:
The work environment characteristics described are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment involving frequent interaction with staff, clients and the general public.