Audit/Coding Validation Support Analyst
OSS Health
1855 Powder Mill Rd
York, PA 17402
United States
Manages Others
No
Experience Required
Yes
Accepts NHA Certifications
Yes
Security Clearance Required
No
Employment Type
Employee
Work Schedule
Full-Time
Travel
No Travel
Job Description
 

JOB SUMMARY:

This position is responsible for reviewing and validating changes for current and upcoming LCD, NCD for medical necessity for reimbursement, for outpatient and inpatient charges. Works closely with HIM Coding Education and Management team.


ESSENTIAL DUTIES AND RESPONSIBILITIES:

· Complies with all policies and procedures.

· Reviews, analyzes, updates and trains staff on coding changes, including LCD and NCD (local coverage determinations and national coverage determinations).

· Responsible for communicating with staff and providers across the organization.

· Consistently and accurately reviews payer updates and changes regarding coding of ICD-10 and CPT.

· Assists department with conducting trend analyses to identify patterns, variations in coding and documentation practices including areas of risk and comparing coding profiles with national and regional norms.

· Demonstrates up-to-date knowledge of healthcare regulatory billing issues, coding mandates, and reimbursement rules and guidelines.

· Produces documents of the highest professional quality: clear, concise and error free; prepared with correct medical terminology and correct use of the English language.

· Performs other duties as assigned.
Job Requirements
QUALIFICATIONS AND EDUCATION:

Education:

High school diploma or GED required; Associate’s degree in relevant field preferred.
Qualifications:

Minimum of 2 years of recent experience in billing, coding and/or payer including but not limited to acute care hospital inpatient, outpatient, surgical and professional fee (Evaluation & Management). Knowledge of Coding, charge posting, payer updates and changes
CPMA, CCS, CPC, CCP, CRCS, CRCS, CRCR, CSPR, CSPPM and/or CCP certification required.
Must have knowledge of Medical Terminology, Anatomy and Physiology, ICD/10, CPT, Coding guidelines and methodologies, Billing, NCCI, LCD, NCD.
Experience with Craneware or related type program desired.
Excellent computer skills required, to include Microsoft Excel and Powerpoint.
Must possess excellent communication and interpersonal skills. Must be able to work in a virtual setting under minimal supervision.
Must have the ability to maintain composure and professionalism in difficult situations.
Must have excellent phone etiquette and be able to operate basic office equipment (copiers, fax, etc.).
3M coding software products or other encoder product experience preferred
Employer
OSS Health
Andrew Matseur
1855 Powder Mill Rd
York PA 17402
United States