Physicians East
Regulatory Services Supervisor
Physicians East, Greenville, North Carolina, United States, 27834
Job Description
Job Description
Regulatory Services Supervisor FLSA: Exempt
About us Physicians East, P.A.is a team of skilled healthcare professionals united to meet the challenge of delivering quality, cost-efficient, comprehensive healthcare to the people of Eastern North Carolina.
About the role We are looking for an employee that can supervise coders and all administrative staff of the Regulatory Services Department. Hybrid role - predominantly remote with some on site requirement as needed.
Supervision Received:
Reports to Regulatory Services Manager.
Supervision Exercised:
Supervises the regulatory services department in their daily duties and activities.
Typical Physical Demands:
Requires prolonged standing or sitting while working in an office environment. Requires some bending or stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, and other office equipment. Requires the ability to distinguish between letters and/or symbols. Requires normal vision range and the absence of color-blindness.
Typical Working Conditions: Hybrid role - predominantly remote with some on site requirement as needed.
Responsibilities Supervises coding services daily to ensure coding levels and charting meets standards and regulations
Provides supervisory oversight to department administrative roles
Informs manager of revisions needed to encounter forms, EHR documentation system, or practice management billing and edit system impacting billable diagnoses or procedures
Remains current on all regulatory coding changes, payor specific requirements, and coding processes that affect reimbursement and contract allowable to ensure proper payment
Conducts and trains staff on coding service levels to ensure documentation supported the level of Evaluation and Management charged
Completes analysis, charts, and spreadsheets to present coding and coding denial outcomes to manager
Educates physicians and employees on coding issues by specialty when coding or documentation issues are identified
Communicate with Coding, Insurance Supervisors, Medicare and BCBS Team members regarding denial trends, problematic denials, reimbursement issues, appeals, and rebilling of claims
Research and correct claims to validate denial adjustments and ensure secondary claims are not held up due to coding issues
Reports all identified compliance audit issues or repetitive use of noncovered diagnoses or codes not paying according to contractual fees schedules to Regulatory Services Manager
Assists internal departments with third party payer coding rules and regulation questions
Shares information as necessary and provides other assistance to the Auditing, Coding and/or Insurance Department as directed by the Regulatory Services Manager
Reports all identified coding compliance audit issues to the Regulatory Services Manager
Maintains patient confidentiality
Coordinate’s student interns from H.I.T. and H.I.M. Programs completing PPE assignment
Prepares weekly student schedules, assignments, and relevant appointments
Attends meetings when required
Location & commitments Full-time role based at our Greenville Arlington Blvd. location, Monday-Friday, 8a.m. – 5 p.m. Overtime may be required to ensure patients are taken care, tasks are completed, and calls are returned in a timely manner. Weekend work is rare but can occasionally be necessary.
Candidate requirements Bachelor’s degree in health information services with RHIA certification and 2-3 years of multi-specialty ICD-10, CPT/HCPCS coding experience
Associates degree in health information technology with RHIT certification and 3-5 years of multi-specialty ICD-10, CPT/HCPCS experience
CCS/CCS-P certification with additional CPC certification and 4-6 years of multi-specialty ICD-10, CPT/HCPCS experience
3 plus years of Medicare and commercial coding/billing experience in a multi-specialty practice required
Must have strong keyboarding, software, analytical and organizational skills. Must possess strong understanding of customer service principles and have well-developed written and oral skills.
Affirmative Action/EEO statement Physicians East, P.A.is an equal opportunity employer and will not discriminate against any applicant or employee on the basis of age, race, color, ethnicity, religion, creed, sex (including gender, pregnancy, sexual orientation, and gender identity, which includes status as a transgender individual), national origin or ancestry, citizenship, past, current, or prospective service in the uniformed services, genetic information (including family medical history), physical or mental disability, or other legally protected status. Reasonable accommodation will be made for persons with disabilities during the application process and/or at the time of employment. Requests for accommodation should be made to the Human Resources Department as early as possible in the
application/employment
process. Contact HR Office at 252-413-6368 or email
careers@physicianseast.com
Disclaimer Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Signatures This job description has been approved by: Manager_____________________________________
Date ____________ HR__________________________________________
Date _________________ Employee signature below indicates the employee's understanding of the requirements, essential functions, and duties of the position. Employee______________________________________
Date__________________
Job Description
Regulatory Services Supervisor FLSA: Exempt
About us Physicians East, P.A.is a team of skilled healthcare professionals united to meet the challenge of delivering quality, cost-efficient, comprehensive healthcare to the people of Eastern North Carolina.
About the role We are looking for an employee that can supervise coders and all administrative staff of the Regulatory Services Department. Hybrid role - predominantly remote with some on site requirement as needed.
Supervision Received:
Reports to Regulatory Services Manager.
Supervision Exercised:
Supervises the regulatory services department in their daily duties and activities.
Typical Physical Demands:
Requires prolonged standing or sitting while working in an office environment. Requires some bending or stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, and other office equipment. Requires the ability to distinguish between letters and/or symbols. Requires normal vision range and the absence of color-blindness.
Typical Working Conditions: Hybrid role - predominantly remote with some on site requirement as needed.
Responsibilities Supervises coding services daily to ensure coding levels and charting meets standards and regulations
Provides supervisory oversight to department administrative roles
Informs manager of revisions needed to encounter forms, EHR documentation system, or practice management billing and edit system impacting billable diagnoses or procedures
Remains current on all regulatory coding changes, payor specific requirements, and coding processes that affect reimbursement and contract allowable to ensure proper payment
Conducts and trains staff on coding service levels to ensure documentation supported the level of Evaluation and Management charged
Completes analysis, charts, and spreadsheets to present coding and coding denial outcomes to manager
Educates physicians and employees on coding issues by specialty when coding or documentation issues are identified
Communicate with Coding, Insurance Supervisors, Medicare and BCBS Team members regarding denial trends, problematic denials, reimbursement issues, appeals, and rebilling of claims
Research and correct claims to validate denial adjustments and ensure secondary claims are not held up due to coding issues
Reports all identified compliance audit issues or repetitive use of noncovered diagnoses or codes not paying according to contractual fees schedules to Regulatory Services Manager
Assists internal departments with third party payer coding rules and regulation questions
Shares information as necessary and provides other assistance to the Auditing, Coding and/or Insurance Department as directed by the Regulatory Services Manager
Reports all identified coding compliance audit issues to the Regulatory Services Manager
Maintains patient confidentiality
Coordinate’s student interns from H.I.T. and H.I.M. Programs completing PPE assignment
Prepares weekly student schedules, assignments, and relevant appointments
Attends meetings when required
Location & commitments Full-time role based at our Greenville Arlington Blvd. location, Monday-Friday, 8a.m. – 5 p.m. Overtime may be required to ensure patients are taken care, tasks are completed, and calls are returned in a timely manner. Weekend work is rare but can occasionally be necessary.
Candidate requirements Bachelor’s degree in health information services with RHIA certification and 2-3 years of multi-specialty ICD-10, CPT/HCPCS coding experience
Associates degree in health information technology with RHIT certification and 3-5 years of multi-specialty ICD-10, CPT/HCPCS experience
CCS/CCS-P certification with additional CPC certification and 4-6 years of multi-specialty ICD-10, CPT/HCPCS experience
3 plus years of Medicare and commercial coding/billing experience in a multi-specialty practice required
Must have strong keyboarding, software, analytical and organizational skills. Must possess strong understanding of customer service principles and have well-developed written and oral skills.
Affirmative Action/EEO statement Physicians East, P.A.is an equal opportunity employer and will not discriminate against any applicant or employee on the basis of age, race, color, ethnicity, religion, creed, sex (including gender, pregnancy, sexual orientation, and gender identity, which includes status as a transgender individual), national origin or ancestry, citizenship, past, current, or prospective service in the uniformed services, genetic information (including family medical history), physical or mental disability, or other legally protected status. Reasonable accommodation will be made for persons with disabilities during the application process and/or at the time of employment. Requests for accommodation should be made to the Human Resources Department as early as possible in the
application/employment
process. Contact HR Office at 252-413-6368 or email
careers@physicianseast.com
Disclaimer Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Signatures This job description has been approved by: Manager_____________________________________
Date ____________ HR__________________________________________
Date _________________ Employee signature below indicates the employee's understanding of the requirements, essential functions, and duties of the position. Employee______________________________________
Date__________________