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Job description
At Houston Methodist, the Audit & Onboarding Specialist position is responsible for planning, coordinating and completing complex documentation, coding and billing reviews. This position serves as a liaison between the Centralized Business Office (CBO) and clinical departments and provides direction and guidance to coders and clinical providers. The Audit & Onboarding Specialist is also responsible for ensuring successful onboarding of physicians regarding compliance in clinical documentation and coding.
nFLSA STATUS
nExempt
nQUALIFICATIONS
nEDUCATION
nnHigh School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)
n nEXPERIENCE
nnSeven years of progressive multi-specialty professional coding experience
n nLICENSES AND CERTIFICATIONS
nRequired
nnMust have one of the following:-CPC - Certified Professional Coder (AAPC)-CPC-H - Certified Professional Coder - Hospital (AAPC)-CPC-I - Certified Professional Coder Instructor (AAPC)-CCS - Certified Coding Specialist (AHIMA)-CCS-P - Certified Coding Specialist Physician-based (AHIMA)
n nSKILLS AND ABILITIES
nnnDemonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
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nnSufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
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nnAbility to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
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nnKnowledge of International Classification of Diseases (ICD) coding, Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS)
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nnKnowledge of healthcare billing and Physicians at Teaching Hospitals (PATH) guidelines
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nnComputer skills to include proficiency in spreadsheet, word-processing, presentation, and compliance tracking software; ability to navigate healthcare regulatory websites
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nnEffective verbal and written communication skills; and effective presentation skills to a variety of audiences
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nnDemonstrates a positive, helpful and supportive attitude and demeanor
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nnAbility for professional handling of confidential/sensitive information
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nnProven ability to analyze information and situations and to identify issues
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nnAbility to deal with difficult issues, maintain objectivity, use good judgment, and envision outcomes when making decisions
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nnAbility to analyze, identify and articulate identified trends and report trends succinctly in a clear and concise manner
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nnAbility to multi-task in a fast paced environment, prioritize projects and apply attention to detail
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nnMust be a self-motivated individual with the ability to think critically and work independently
n
n nESSENTIAL FUNCTIONS
nPEOPLE ESSENTIAL FUNCTIONS
nnnOnboards new clinical practitioners, including but not limited to physicians, nurse practitioners, and physician assistants, to ensure they are documenting and coding appropriately for all services provided.
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nnReviews coding accuracy and provides review results to the coding supervisor(s).
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nnProvides ongoing documentation, coding, and billing education to employees as needed.
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nnCollaborates with the CBO to communicate audit results. Delivers a list of exceptions needing corrective action.
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n nSERVICE ESSENTIAL FUNCTIONS
nnnProvides quality assurance, direction and guidance to departments.
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nnDemonstrates the components of the Houston Methodist Experience Service Standards and translates them into specific expectations to anticipate and meet customer needs.
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nnEnsures protection of private health and personal information. Adheres to all Health Insurance Portability and Accountability Act (HIPAA) compliance regulations.
n
n nQUALITY/SAFETY ESSENTIAL FUNCTIONS
nnnDesigns, delivers, and assesses educational materials for use in physician/staff training modalities.
n
nnMonitors provider progress as directed by management to ensure adherence to regulations and policies and procedures.
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nnDesigns and completes annual documentation and coding review plan. Delivers a summary outlining the review completed and the action items needed.
n
n nFINANCE ESSENTIAL FUNCTIONS
nnnEnsures all charges performed are documented and billed appropriately in a timely manner.
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nnReviews physician coding trends and identifies areas of opportunity for improved coding, documentation and/or charge capture.
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nnAudits new provider documentation and coding in a timely manner to ensure charges and payments are not delayed.
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n nGROWTH/INNOVATION ESSENTIAL FUNCTIONS
nnnMaintains current knowledge of coding industry standards, policies, and procedures.
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nnAssists in writing policies, protocols, and procedures to address billing compliance and documentation issues; including drafting and working with others to edit and adopt.
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n nSUPPLEMENTAL REQUIREMENTS
nWORK ATTIRE
nnnUniform: No
n
nnScrubs: No
n
nnBusiness professional: Yes
n
nnOther (department approved): No
n
n nON-CALL *
n*Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.
nnOn Call* No
n nTRAVEL **
nTravel specifications may vary by department
nnnMay require travel within the Houston Metropolitan area Yes
n
nnMay require travel outside Houston Metropolitan area No
n
n nQUALIFICATIONS
nEDUCATION
nnHigh School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)
n nEXPERIENCE
nnSeven years of progressive multi-specialty professional coding experience
n nLICENSES AND CERTIFICATIONS
nRequired
nnMust have one of the following:- CPC - Certified Professional Coder (AAPC)- CPC-H - Certified Professional Coder - Hospital (AAPC)- CPC-I - Certified Professional Coder Instructor (AAPC)- CCS - Certified Coding Specialist (AHIMA)- CCS-P - Certified Coding Specialist Physician-based (AHIMA)
n nCompany Profile:
nHouston Methodist Specialty Physician Group is an integral part of Houston Methodist's overall strategy to become one of the nation's leading academic medical centers. Established as a nonprofit corporation certified by the Texas State Board of Medical Examiners, the Specialty Physician Group enables physicians to maintain autonomy with respect to clinical practice while growing their practice within an academic environment.
nHouston Methodist is an Equal Opportunity Employer.
Worksite address
nashville, TN, 37247, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.