Hours
:
Shift Start Time:
Variable
Shift End Time:
Variable
AWS Hours Requirement:
8/40 - 8 Hour Shift
Additional Shift Information:
Weekend Requirements:
As Needed
On-Call Required:
No
Hourly Pay Range (Minimum - Midpoint - Maximum):
$36.830 - $47.530 - $53.230
The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.
Please Note:
As part of our recruitment process, you may receive communication from Dawn, our virtual recruiting assistant. Dawn helps coordinate scheduling for screening calls and interviews to ensure a smooth and timely experience. Rest assured, all candidate evaluations and hiring decisions are made by our recruitment and hiring teams.
What You Will Do
To provide coding support and appeal guidance relating to reimbursement issues. Research and propose recommended action on policies and regulations to enable Sharp HealthCare entities to obtain the highest possible reimbursement. To act as a liaison between PFS Business Office Staff and Regulatory Compliance department. Utilize the payer contract tool to report payer trends.
Required Qualifications
- 5 Years Experience with coding, auditing and patient account follow up in a business office
- Certified Professional Coder (CPC) - AAPC -REQUIRED
Preferred Qualifications
Essential Functions
System Integration:
Ensures timely coding and reimbursement tools are supplied to physicians, peers and subordinates. This position serves as a resource for staff to have outstanding accounts reviewed for documentation supported by coding reviewed in order to perform timely follow-up collections and claim form submissions.
Demonstrates Effective Customer Relations By:
Consistently communicate with Executives, Operations Senior Management, department members and other Sharp employees in a pleasant, professional and effective manner.
Respond appropriately to needs, preferences and dissatisfactions expressed by customers within a time period appropriate to the request.
Maintain confidentiality.
Ensure effective, customer-focused operations of responsible areas.
Provide effective consultation and support services to Executives, Operation Senior Management, to assist in strategic and operational planning and facilitate achievement of organizational and departmental goals.
Assist in analyzing and interpreting trends and variances requiring Manager Business Service and/or Manager of Quality control's attention.
- Leadership Assessment Rating by Manager of Business Service and Manager Quality Control/Peers: Provides effective leadership of the position, including properly motivating peers, ensuring optimum levels of productivity, reengineering workloads, etc.
Financial:
Ensures entity-specific quantitative and qualitative analyses are completed and communicated. Provide educational lectures on regulatory changes to CCD staff when required.
- Quality Documents and updates system usages related policies and procedures. Reviews System capabilities to ensure user functionality and satisfaction in accordance with corporate goals and objectives. Coordinates and/or assists the medical group in the establishment of correct coding tools for compliant billing and reimbursement. Investigate user problems; perform troubleshooting activities and communicates resolution to the affected parties. Provide coding and reimbursement analysis PFS/CCD and medical group.
- Reimbursement and appeals
Coding Guidelines And Tools For Reimbursement:
Responsible for the planning, coordination and accumulation of documentation for the preparation of meaningful, accurate and timely appeals and the quantitative and qualitative analyses and supporting documentation thereto.
Reopenings & Appeals:
Responsible for the planning, coordination and accumulation of documentation for reopening items or appeal issues the Manager of the Business Office and or Quality requests. Provide documentation timely and accurately so that the reopenings or appeals meet all filing deadlines.
Demonstrates Effective Customer Relations By:
Consistent communication with Physicians, Operations Staff, Management, department members and other Sharp employees in a professional and effective manner; responds appropriately and timely to needs, preferences and dissatisfaction expressed by customers.
Ensures effective, customer-focused operations; analyzes and evaluates the rejection volume of fee for service reimbursement.
Effectiveness:
Recommend and assist with the implementation of techniques to improve productivity, increase efficiencies, reduce costs, and maintain state of the art practices.
Ensure compliance with corporate policies, keep abreast of current trends in healthcare, accept interpersonal differences, respecting others values and opinions and promoting cooperation, effectively prioritizing workload to meet required deadlines and setting goals and objectives in conjunction with the manager.
Offer ongoing training and consulting to customers. Participate in all meetings related to coding and compliance.
Knowledge, Skills, And Abilities
- The position requires strong verbal and written communication skills and the ability to effectively communicate with all levels of the organization, including significant interaction with Business Office, Regulatory Compliance and Senior Management.
- The candidate must be able to analyze and interpret data, as well as prepare or direct the preparation of concise, accurate and meaningful documentation.
Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class
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