Manages daily billing operational activities related to busy Otolaryngology practice at St. Elizabeth’s Medical Center in Brighton, MA. Reviews surgical/clinical records to assure accurate specificity of diagnoses, procedures, and appropriate reimbursement for professional and/or facility charges. Effectively utilizes ICD-10, CPT, and HCPCS modifier and/or other codes according to coding guidelines. Communicates regularly with staff physicians to ensure documentation, code capture, and billing are within compliance guidelines. Works closely with Steward Medical Group corporate coding team in performing chart audits, ensure proper code assignment, and review denial/reimbursement reports. Evaluates and implements educational programs to support current coding practice. Reports to practice Operations Director. The position is full-time.
• Supervises all coding activities and workflows and is content expert for providers (MDs, APPs, etc.)
• Provides applicable training for providers on proper coding/documentation.
• Manages operations within the established guidelines (compliance, budget, productivity, etc.)
• Create and maintain department processes and controls
• Performs pre/post chart audits to ensure coding accuracy
•Codes all claims and is responsible for timely and accurate charge capture relative to monthly budget targets
• Ensure compliance with state and federal regulations, rules and regulations, and policies & procedures.
• Evaluates and implements educational programs to support current coding practice.
• Serve as information liaison on coding-related information and activities to the practice.
• Coordinates with other departments to facilitate the coding process and revenue cycle performance.
• Focus on continuous improvement.
• Act as a resource on projects and takes on other duties as assigned
• Maintains certifications and stays current on industry trends (e.g. CMS guidelines, ICD-10-CM/CPT changes, resolves coding and documentation regulatory issues).
• Bachelor's degree preferred
• 3-5 years professional coding experience required
• Professional coding certification (CPC, CCS-P) required
• Certified Risk Adjustment Coder preferred; Risk Coding experience preferred
• Prior expertise in physician practice claims management, coding, E&M Leveling and HCC Risk.
• Strong Preference for candidates with Otolaryngology experience, but not required.
• Demonstrated coding (ICD-10-CM and CPT) expertise.
• Demonstrated knowledge of health information processes
• Excellent problem-solving ability, communication, leadership, initiative, and management skills are a necessity.
• Certification in Health Care Compliance (CHC) highly desired.
• Special skills required include: a thorough knowledge of medical terminology, anatomy & physiology, disease processes, health information science, computer applications in medical records, and current dynamics in the health care industry.
Steward Health Care is an Equal Employment Opportunity (EEO) employer, Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, and or expression or any other non-job-related characteristic.
Steward Medical Group is taking additional necessary preparations to ensure patients can receive compassionate care in safe, carefully managed environment – with confidence and without fear.
Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience.
- Any COVID-19 related care takes place in designated areas away from other patients and their families.
- A stringent cleaning policy has been implemented throughout our facilities.
- A strictly controlled visitor and mask policy is required for patient and colleague safety.
Steward Health Care is the largest private, for-profit health care network in the United States. The company is owned and led by a management team of Steward physicians. Headquartered in Dallas, Texas, Steward employs more than 40,000 health care professionals and operates 35 hospitals across the United States and in the countries of Malta and Colombia which regularly receive top awards for quality and safety. The Steward network includes multiple urgent care centers and skilled nursing facilities, substantial behavioral health services, more than 7,000 beds under management, and approximately 2.2 million full risk covered lives through the company's managed care and health insurance services.
The Steward Health Care Network includes more than 5,000 physicians across 800 communities who help to provide more than 12 million patient encounters annually. Steward Medical Group, the company's employed physician group, provides more than six million patient encounters per year. The Steward Hospital Group operates hospitals in Malta, Colombia and nine states across the U.S., including Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, Texas, and Utah. For more information, visit www.steward.org.