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Director Medical Coding and Chart Audit Services HCS

Catholic Health
Buffalo, NY Other
POSTED ON 4/3/2025
AVAILABLE BEFORE 5/2/2025
Salary: 72,618.00-108,927.00 USD

Facility: Administrative Regional Training Cntr

Shift: Shift 1

Status: Full Time FTE: 1.066667

Bargaining Unit: Catholic Health Emmaus

Exempt from Overtime: Exempt: Yes

Work Schedule: Days

Hours

Monday to Friday: 8 - 5

Summary

Responsible for the overall efficient operation of CHS Outpatient Coding and Private Client Medical Coding and Chart Audit Services.

Responsibilities

SKILL AND EDUCATIONAL REQUIREMENTS (MINIMUM):

The successful candidate will have: A thorough understanding of Current Procedural Terminology (CPT) codes, International Classification of Diseases (ICD-10) diagnosis codes and appropriate modifier use. Experience with AHA Coding Clinic and CPT Assistant as resources

  • Requires extensive knowledge of Medicare and Commercial Payers coding and billing policies. They will ensure documentation compliance with governmental and third-party Payer regulations
  • Knowledge of National Correct Coding Initiatives (NCCI) edits, National and Local Coverage Determination Policies (NDC and LDC) and Medically Unlikely Edits (MUE)
  • Strong research capabilities with respect to Medical procedures and technology; and an excellent knowledge of Medical terminology
  • Excellent computer skills- Word, Excel, multiple EHR systems and electronic encoders
  • Excellent communication skills- Daily communication with Clients as well as supervising a talented and diverse team of Medical Coders
  • Works well in a team environment and has the capability to multi-task several responsibilities
  • Recognizes and protects the confidentiality of all patient and employee information according to HIPAA policy.
  • Interfaces well with external and internal Professionals at all levels- Medical, Legal, and Clerical

EDUCATION

  • Minimum of Bachelor's degree in a related health or science field with 5 -10 years of Medical Coding experience
  • Medical Coding certification through American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is also required with multiple certifications a plus

Experience

  • 5- 10 years of multi-specialty coding with supervisory experience

KNOWLEDGE, SKILL AND ABILITY

  • Resolves insurance denials through the research of Payer policies, NCCI edits, and coding guidelines
  • Updates and maintains Payer policies specific to each Client along with databases of coding guidelines
  • Educates Clients and staff on correct Coding guidelines and provides annual CPT, ICD-10, and vaccine updates
  • Supervises and mentors the Medical Coding Team to ensure they provide Clients with the highest level of Medical Coding service
  • Responsible for overseeing all audit activities- internal, external, and third-party prospective and retrospective payer audits including Federal and State agencies. Ensures compliance of CPT and Medicare regulations with respect to Coding and documentation guidelines

Working Conditions

  • Normal heat, light space, and safe working environment; typical of most office jobs
  • Long periods of sitting

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