***Remote Position. Candidates living in the Southeast region will be considered.***Essential Duties:Provide leadership to coding review and charge capture staff. Ensure that equity of workloads, productivity goals and assignments are maintained. Assigns monthly benchmarks, weekly activities and daily priorities as appropriate to ensure timely completion of dutiesEstablish protocols to ensure Revenue IntegrityPlan and direct audits to evaluate the adequacy and accuracy of documentation in support of services billed, including CPT/ICD-10/HCPCS and other third-party payer codes, medical necessity of services, compliance with other documentation and coding and billing standardsLead the evaluation of the adequacy and effectiveness of internal and operational controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to coding and billing, federal and state regulations and guidelines, CMS and other third-party payer billing rules, and OIG compliance standardsEstablish and implement a physician education program to include documentation educationServe as a subject matter expert and authoritative resource on interpretation and application of documentation and coding rules and regulations, and conduct enterprise risk assessments of potential and detected compliance deficienciesStay current on relevant coding and billing regulations and enforcement trends, specifically as they relate to provider-based coding and billing to include updates to key stakeholdersDevelop standards and guidelines for medical record documentation including reporting on deficiencies and training to remediateCollaborate with Compliance Officer on compliance, coding documentation and risk management when requiredDevelop the annual compliance work plan sections relating to coding and billingWork closely with company's physicians, Operations and Revenue Cycle Leadership to validate controls and monitor high risk areasPerform coding and billing documentation and charge audits, according to best practicesResponsible for coaching, professional development, and mentoring coding and data entry staffDevelop documented policies and processes related to the management of coding and billing compliance mattersDevelop edits within claims scrubber EHR software including testing and validationPrepare and provide coding education to organization physicians, providers and staffResponsible for effective identification of staffing resources, recruitment and allocation of resourcesProvide guidance and motivation to staff regarding identification of activities/areas where performance can be improvedResponsible for making recommendations and/or decisions for hiring, corrective actions, terminations, and performance evaluationsOther duties as assigned by the Vice President of Revenue Cycle ManagementRequired Qualifications: Certified Professional Coder- AAPC CertificationsCoding compliance experienceBachelor's degree or equivalent work experienceOrthopedic physician practice and/or surgery center experienceAdvanced Knowledge of:Documentation, coding and billing rules/guidelinesCPT/ICD-10/HCPCS coding rulesMedical terminology and healthcare compliance audit requirementsCMS regulations and guidelinesMinimum of 10+ years of management experience in a physician or healthcare MSO organizationAbility to manage and direct others in a fast-paced, team-oriented environment including remote indirect and direct reportsIndependent judgment; effective, team-oriented leadership skills.Excellent analytical, problem-solving and decision-making skillsExcellent communication skills (verbal, written & presentation)Excellent computer skills with strong proficiency in reporting, spreadsheet applications and experience with Microsoft OfficeTravel up to 25% as needed for practice support, coding audits, learning and development, coding team member coaching, etc.Preferred Qualifications:Certified Orthopedic Surgery CoderPhysical Requirements: Physical requirements for the position include the ability to frequently hear and communicate orally, see up close and at a distance, read and comprehend, stand, sit, walk, reach, handle, and/or feel objects. Must be able to climb, pull, push and kneel. Maximum unassisted lift = 25 lbs. Average lift less than 10 lbs. Must be able to work extended hours as necessary. Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
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Coding Director (Remote)