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Skills
Analysis Skillsunmatched
Automationunmatched
Clinical Validationunmatched
Coachingunmatched
Corporate Complianceunmatched
Documentationunmatched
HIPAA (Health Insurance Portability and Accountability Act)unmatched
Information Technology & Information Systemsunmatched
Legalunmatched
Medical Billingunmatched
Medical Codingunmatched
Medical Record Systemunmatched
Medical Recordsunmatched
Monitor Regulationsunmatched
Training Programunmatched
Training/Teachingunmatched
Trend Analysisunmatched
Description
Essential Functions:
Audits charts and revies clinical records ensuring all diagnostic and procedural codes and modifiers strictly adhere
Identifies trends in improper coding or other communication shortcomings that may lead to claim denials or audits
Complies with all medical coding guidelines and monitors evolving regulatory and industry changes
Provides targeted education, direct coaching, and facilitates training programs tailored to each medica specialty upon translating audit findings
Follows up and clarifies any information that i s not clear with the rendering provider
Collaborates with IT and EHR teams to improve charge automation and optimize workflows
Conducts ad-hoc audits to ensure fidelity to coding guidelines
Relevant expert for Southwest Network on accurate and efficient coding practices
Analyze medical records and identify documentation deficiencies
Nonessential Functions:
Follows policies and procedures and adheres to the requirements of the Corporate Compliance Program
Ensures confidentiality of verbal and written information in accordance with HIPAA standards and Southwest Network policy, and adheres to the legal, ethical and professional guidelines adopted by Southwest Network