PHYSICIAN TRAINER, COMPLIANCE
Location: Boston Massachusetts
Description: Massachusetts General Hospital (GHC) is looking of PHYSICIAN TRAINER, COMPLIANCE right now, this occupation will be placed in Massachusetts. More details about this occupation opportunity kindly read the description below. Job Description
Compliance Analyst and Educator
(or Compliance Physician Trainer for Billing Compliance and Coding)
The Massachusetts General Hospit! al and Massachusetts General Physicians Organization (MGPO) Billing Compliance Office (BCO) includes a seasoned team of coders, clinicians and data analysts who assess organization risk through the review of clinical documentation, billing claims information and billing data and deliver feedback to clinical departments though written and face to face communications, including individual and group training.
Job Description
Reporting to the Director of Billing Compliance, the Compliance Analyst and Educators are members of a dynamic team of certified coders, nurses and data analysts who assess, analyze and report on the quality of visit, procedure and diagnosis coding relating to patient record documentation, delivers ongoing regulatory education related to billing compliance to both MGH and MGPO clinical caregivers and administrative staff, and supports the ongoing documentation, coding and billing improvement initiatives of the Billing Compliance Office.
Principal Responsibilities
Audit and analyze ! the documentation accuracy, medical necessity and billing code selection of clinical and billing providers in alignment with CMS, OIG and other applicable professional and technical services regulations and guidelines [1]
Effectively monitor and report detailed feedback to appropriate clinical and administrative providers, following up and referring to supervisors when necessary
Work collaboratively with coding and billing team representatives to evaluate complex billing issues, and initiate appropriate internal and external audit responses, including record retrieval, refunding, rebilling or appealing based on established guidelines
Work with department or clinical specialty management and staff to assess operational risks
Design and deliver effective new provider training and ongoing training to MGH caregivers and administrative staff on the rules and regulations related to billing compliance and coding
Serve as a liaison to Partners Corporate, third p! arty payers and regulatory entities for clarification and interpretation of billing guidelines and documentation
Assist in the development of new compliance guidelines, procedures, and training programs designed to enhance the effectiveness of the BCO, including the participation of personal development activities
Required Skills and Competencies
Ability to manage multiple projects simultaneously and succeed in meeting deadlines and productivity goals
Effective communication and teaching skills adaptable to both clinical and administrative staff of all levels
Forward-looking critical thinking and decision-making capabilities for the creation and tailored application of compliance guidelines
Technical capacity to utilize multiple billing systems, medical record systems, and Microsoft applications [2]
A professional and team player approach toward work
Qualifications
CCS, CPC, RHIA or equivalent coding certificate required wi! th 3-5 years experience performing CPT/HCPCS and ICD-9 coding required !
or clinical degree with 3-5 years experience performing CPT/HCPCS and ICD-9 coding required
Nursing or clinical background strongly preferred
Bachelors Degree or equivalent experience required
[1] Office of Inspector General (OIG) Annual Work Plan, AMA ICD-9 diagnosis and CPT coding guidelines, CMS's Teaching Physician rules, CMS's Correct Code Initiative (CCI), etc.
[2] MD Audit, IDX and PAT COM billing systems, LMR/CAS electronic medical record systems, and Microsoft applications (excel, powerpoint, word, etc.)
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If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to Massachusetts General Hospital (GHC).
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This occupation starts available on: Mon, 01 Apr 2013 14:47:23 GMT