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Enterprise-Wide Coding Analyst

Company: Presbyterian Healthcare Services
Location: Albuquerque
Posted on: February 16, 2020

Job Description:

Job Description Type of Opportunity: Full Time FTE: 1.000000 Exempt: No Work Schedule: DaysSummary:With supervision directly supports the following responsibilities of the Enterprise-Wide Coding team: maintain and update enterprise-wide and department coding policies and procedures for PHS; monitor compliance to all external regulatory agency coding rules and regulations; coordinate internal and external enterprise-wide coding audits for all areas within PHS conducting coding; summarize and track internal and external audit results for all of PHS; coordinate and track enterprise-wide training of all PHS coding, audit, physician and clinician personnel; support via tracking the enterprise-wide corrective action plans for coding, audit, physician and clinician personnel identified as low performers; perform medical record and billing reviews of denied and appealed claims with assistance of coder and clinical auditors; compile and analyze Enterprise-Wide Coding scorecard metrics for coding related denials and appeals and overall coding accuracy results based on both internal and external audits; research regulatory agency regulations; correct patient accounts based on internal and external audit findings. *Liaison to the Manager, Information Services, Finance/Patient Financial Services, all hospitals, all PMG sites, PHP, Home Health, Albuquerque Ambulance, Compliance and all ancillary departments in addressing functional coding, auditing, compliance and training issues and problems.*Responsible for maintaining accurate, complete and timely documentation in either electronic or hard copy form.*Maintains and disseminates up-to-date technical knowledge of legal and regulatory information from all appropriate jurisdictions concerning the given business area. This includes but is not limited to all ICD-9, CPT-4, HCPCS and APC updates and changes.*Researches coding, billing and charging compliance issues, recommends and implements corrective action plans that assure compliance with regulatory agencies where appropriate. *Responds to inquiries and requests daily regarding coding and auditing issues and problems and ad-hoc analysis for all PHS management.*Gathers and analyzes information and provides recommendations to address and resolve business issues for a specific business group.*Responds to client problems and inquiries via the telephone and e-mail.*Maintains up-to-date working knowledge of all PHS coding and auditing IT applications.*Researches and investigates external and internal customer concerns regarding patient care and/or billing of patient care. *Analyzes and summarizes data from medical record and account audits and communicate results and findings to management.*Documents via information systems the responses and resolutions to both internal and external customer inquiries and issues to ensure high quality and standardized responses as well as tracking and reporting capability. *Provide assistance in audit research and documentation.About Us Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees.Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans. We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come. About New Mexico New Mexico's unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque's International Balloon Fiesta, Los Alamos' nuclear scientists, Roswell's visitors from outer space, and Santa Fe's artists, and you get an eclectic mix of people, places and experiences that make this state great. Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC. New Mexico offers endless recreational opportunities to explore, and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. Requisition ID: 2020-13772 Street: 9521 San Mateo NE Name: CODING AND DOCUMENTATION QA JobTitle: Enterprise-Wide Coding Analyst

Keywords: Presbyterian Healthcare Services, Albuquerque , Enterprise-Wide Coding Analyst, Professions , Albuquerque, New Mexico

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