Naples Comprehensive Health (NCH)
Naples Comprehensive Health (NCH)
ABOUT NCH
NCH is an independent, locally governed non-profit delivering premier comprehensive care. Our healthcare system is comprised of two hospitals, an alliance of 700+ physicians, and medical facilities in dozens of locations throughout Southwest Florida that offer nationally recognized, quality health care.
NCH is transforming into an Advanced Community Healthcare System(TM) and we’re proud to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass, and ProScan.
Join our mission to help everyone live a longer, happier, healthier life. We are committed to care and believe there's always more at NCH – for you and every person we serve together. Visit nchjobs.org to learn more.
JOB SUMMARY
The Physician Documentation Specialist NCH Medical Group is responsible for monitoring provider documentation and provide input with developing programs to assist the NCHMG organization to meet the existing and future quality and requirements dictated by CMS and other contracted payers. This position collaborates with providers and other healthcare team members to make improvements that result in accurate and comprehensive documentation. Increase provider awareness regarding documentation and its influence on reimbursement and revenue capture. The Physician Documentation Specialist will assist the Manager of Physician Auditing & Documentation with developing and delivering provider and NBC staff education based on coding guidelines and federal and state regulations. Additionally, this position will improve accuracy and reliability of data while promoting appropriate documentation practices. Identifies where additional education is needed and assists in developing and implementing processes to minimize or eliminate risk. Collaborates with the IT Department when necessary to ensure the providers are using the EHR in accordance with the said requirements. This individual must also be able to communicate effectively with providers, staff and other leadership and participate in the continual improvement of Physician documentation.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Other duties may be assigned.
· Audits medical records to ensure that regulatory guidelines are met for proper coding with an emphasis on documentation, coding improvement, and revenue capture. Under the direction of the Manager Physician Auditing & Documentation, provides education to clinicians, clinical staff, and others as needed via face-to-face meetings, classroom settings, webinars, and written modules
· Assists the Manager Physician Auditing & Documentation with external third-party Auditor
· Real time resource to providers for documentation and coding questions.
· Acts as a resource to Coders and A/R team after standard resources options have been unsuccessful.
· Maintains, improves, and manages educational content. Continues to monitor and improve the effectiveness of ongoing education programs.
· Responsible for ensuring that provider documentation supports the assigned ICD10, CPT, and HCPS coding.
· Assists in determining educational needs based on documentation reviews, provider/coder’s staff feedback, and data analysis.
· Assists Manager Physician Auditing & Documentation with records requests from CMS and other payors.
· Maintains a high level of competency related to clinical documentation and coding in assigned specialty and other areas and compliance with government regulations by attending appropriate workshops and seminars and web-based training courses for continued education.
· Performs special projects; analyzes processes and related data to recommend automation and workflow improvements.
· Assists with the development and execution of physician education strategies resulting in improved documentation.
· Effectively communicate with NBC staff to glean insight into potential risks due to documentation.
· Helps providers further their ICD-10 specificity requirements as directed by government and organizational policies and procedures.
· Reviews effectiveness of training and education; re-educates when applicable and informs Management of documentation issues beyond his/her scope of responsibility.
· Assists Manager Physician Auditing & Documentation with Analytical review of denial reports to identify denials due to insufficient documentation.
EDUCATION, EXPERIENCE AND QUALIFICATIONS
· Minimum of High School or GED required. Associate Degree preferred.
· Minimum of 3 years of experience in medical coding required.
· Minimum of 1 year of experience in auditing medical billing for correct CPT and ICD10 codes required.
· Must be a Certified Professional Coder (CPC) through an accredited national organization such as the American Academy of Professional Coders (AAPC) or NAMAS.
· Certified Professional Medical Auditor (CPMA) preferred.
· Experience coding or auditing evaluation and management encounters preferred.
· Must have excellent communication skills- both verbal and written
· Knowledge of CPT and ICD-10 codes – evidence of updated education
· Knowledge of medical terminology
· Proven self-starter with ability to motivate personnel.
· Knowledge of CMS and other insurers documentation and billing requirements
· Intermediate computer knowledge: Microsoft Word, Excel, Outlook, and Windows