Coding and Compliance Specialist
Esse Health is the largest independent physician practice in the St. Louis Metropolitan area with over 115 physicians, in 45 locations, serving nearly 130,000 patients. We are leading the health care community by placing patients and their physicians at the center of health decisions. Esse Health is more than a healthcare provider – it’s a place where medicine is a calling and not just a profession. It’s a team of extraordinary medical professionals with the latest ideas for keeping patients healthier.
Esse Health is currently seeking a Coding & Compliance Specialist to work out of its’ Central Business Office located in Creve Coeur, MO.
Under the direction of the Director of Coding and Compliance, reviews physician’s health records to ensure proper coding and documentation with all third-party billing and compliance regulations.
- Schedules and performs medical chart audits for compliance with government and third-party payor regulations. Provide feedback to practitioners regarding audit results and educate them on proper coding techniques and or/compliance regulations.
- Audits each note for correct coding. The note will be reviewed for coding compliance with CPT/ICD-10 coding guidelines and the proper use of HCC codes.
- Conducts physician audit for correct assignment of Evaluation and Management code.
- A report should be generated for each provider to summarize any discrepancies in documentation and coding, which will be reviewed upon meeting with the provider.
- Report to the Director of Coding and Compliance on the number of audits performed weekly, and track ongoing provider audit statistics.
- Report any trends of poor documentation or other issues to the Director of Coding and Compliance.
- Conducts bi-monthly specialty coding audits to ensure accurate code selection by the remote coding consultants
- Provides training to providers regarding coding and documentation policies.
- Stays up to date with updates on ICD-10, CPT and HCPCS codes.
- Assist clinical staff and insurance department with policy interpretation and coding questions, as needed.
- Educates sites on implementation of use of new codes.
- Assists with NextGen upgrade testing. Provide backup NextGen Electronic Health Record (EHR) support as needed to sites.
- Assists with special projects and performs other duties as assigned.
- Licensure/Certification: RHIA, RHIT, and CCS-P or CPC
- Years of Experience: 5 years experience with all aspects of physician coding with emphasis on Evaluation and Management coding. Prior knowledge of Medicare coding rules. Auditing experience is a plus.
Knowledge, Skills & Abilities:
- Prior knowledge of medical terminology and experience with ICD-10-CM diagnosis coding required
- Must be detail-oriented and able to effectively communicate with physicians and physician office staff
- Must be computer literate with experience in Word & Excel
- Multiple medical coverage benefits
- Generous PTO policy + 8 paid holidays
- 401k match + profit sharing
- Tuition reimbursement
- Wellness program
Instructions for Resume Submission: