Coding and Payer Guideline Trainer

Closing Date: November 30, 2011

Company:	Healthcare Billing and Managment Association Job Board Laguna Beach, CA
Job Location:	Avon, CT (Hartford County)
Employment Type:	Full Time
Department:	Womens Health USA

Description:

We're Women's Health USA, The Business Partner for Physicians. Since 1997, we've dedicated ourselves to providing expert business services to physicians and their patients. Physicians come to us to manage the business of medicine so they can focus on caring for patients. Whether it's our full complement of practice management, billing and collection, revenue enhancement and clinical services for ob/gyns, urogynecologists, reproductive endocrinologists, and other women's health specialists, or billing and collection services for family practices, cardiologists, and specialty groups, we serve as your "back room" - your business support team. Our specialized technologies, dedicated and experienced teams of experts, proven business strategies and industry-leading business solutions make us your preferred business partner.

Duties:

I. PURPOSE OF THE JOB: Comply with guidelines and standards of The American Medical Association (AMA), The Center for Medicare and Medicaid Services (CMS) and The American Academy of Professional Coding (AAPC) to provide training and education for internal staff, external staff and physicians on coding related issues. Researching and updating insurance company guidelines. Monitor, maintain and communicate all industry related coding initiatives and changes.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

• Serves as a representative of Women’s Health, displaying courtesy, tact, consideration and discretion in all interactions with other members of the Women’s Health communities and the public.
• Monitor, maintain and communicate all industry related coding initiatives and changes.
• Develop and provide coding related training to for internal staff, external staff, and physicians on a regular basis and as issues are identified. Trainings to take place on site at Division, Central Billing Office or other facility as needed.
• Develop, communicate, maintain and work with other members of the Women’s Health community to create, update, maintain and communicate insurance specific guideline information.
• Communicate all coding related issues and concerns to Coding Manager and Book of Business Head.
• Recommend new rules for Claims Scrubber.
• Attend and participate in insurance company provider representative meetings on an as needed basis.

II. OTHER DUTIES AND RESPONSIBILITIES:

• Follow internal protocols regarding departmental communications.
• Participate in proactive team efforts to achieve departmental and company goals.
• Adhere to corporate compliance program guidelines and comply with all safety policies, practices and procedures within the Women’s Health community.
• Advise supervisor of any problem situations.
• Provide assistance in Coding Department as needed.
• Assist Quality Assurance Department as needed.
• Adhere to all corporate compliance mandates and guidelines.
• Comply with all corporate safety policies, practices and procedures.
• Maintain and respect the confidentiality of PHI (Protected Health Information) in accordance with insurance collection guidelines, corporate policy and all HIPAA (Health Insurance Portability and Accountability Act) mandates. Candidate will have access to PHI based on the HIPAA minimum necessary standards
• Other duties as assigned by management

Qualifications:

III. KNOWLEDGE AND SKILLS:

• High school diploma or GED
• Experience using CPT, HCPCS and ICD codes
• Must be a Certified Professional Coder through the American Academy of Professional Coding and maintain required CEU’s annually
• Must have a minimum of three (3) years of prior medical billing experience.
• Must have a minimum of one (1) year of prior training experience.
• Computer skills as evidenced by proficiency and/or training with applicable software.
• MS Office experience
• Ability to work with minimal direct supervision
• Ability to set priorities

IV. EXTENT OF PUBLIC CONTACT (within and outside WHC):

• Interact with the public (physicians, insurance companies, internal Women’s Health community etc.) via in-person, telephone and or written communication in a courteous and tactful manner to answer concerns, questions and or resolve any issues

V. PHYSICAL DEMANDS:

• Ability to remain seated for up to 8 hours per day.
• Ability to travel to offsite locations as required.
• Ability to work in fast-paced environment.

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