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Category: Management/Professional
Facility: IHA Administration
Department: Compliance
Schedule: Full Time
Hours: 40 Hours
Job Details: 1 - 3 years of experience required

POSITION DESCRIPTION:

 

Point of contact for IHA offices for proper coding procedures and workflow for existing medical services; provides support for the development and maintenance of IHA coding and billing standards and IHA fees.  Surgery experience required. 

 

ESSENTIAL JOB FUNCTIONS:

 

1.      Researches and provides written processes for correct coding.

2.      Provides training for IHA staff and physicians on ICD 10 coding standards and procedures.

3.      Works closely with IHA's Compliance Team to maintain coding standards and procedures in alignment with regulatory and payer requirements.

4.      Ability to analyze RBRVU data in correlation to IHA's fee schedule; ability to effectively navigate through NextGen and other relevant practice management systems specifically with respect to understanding billing and office procedures.

5.      Performs other duties as assigned.

 

 

ORGANIZATIONAL EXPECTATIONS:

 

1.      Creates a positive, professional, service-oriented work environment by supporting the IHA CARES mission and core values statement.

2.      Must be able to work effectively as a member of the Compliance team.

3.      Successfully completes IHA's "The Customer" training and adheres to IHA's standard of promptly providing a high level of service and respect to internal or external customers.

4.      Maintains knowledge of and complies with IHA standards, policies and procedures, including IHA's Employee Handbook.

5.      Maintains general knowledge of IHA office services and in the use of all relevant office equipment, computer, and manual systems.

6.      Serves as a role model, by demonstrating exceptional ability and willingness to take on new and additional responsibilities.  Embraces new ideas and respect cultural differences.

7.      Uses resources efficiently.

 

 

MEASURED BY:

 

Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.

 

 

 

ESSENTIAL QUALIFICATIONS:

EDUCATION:  Bachelor's Degree or equivalent combination of education and experience.

CREDENTIALS/LICENSURE: CPC or certification from AHIMA required.

MINIMUM EXPERIENCE:  2 years of experience coding and medical record auditing.  Previous experience with surgery required, primary care and multi-specialty care preferred, other relevant experience would include provider relations or customer service representative work with a health care insurance organization. Claims payment and data management experience is highly desirable.

 

 

POSITION REQUIREMENTS (ABILITIES & SKILLS):

1.      Demonstrated understanding and/or hands-on experience with office processes, procedures and workflows.

2.      Substantial knowledge of managed care and insurance practices, insurance claims and billing process, fee schedules and pricing.

3.      Maintains working knowledge of federal, state, and insurance company regulations and contract requirements affecting compliance in a healthcare setting; compliance plan and auditing standards.

4.      Proficiency in multi-tasking and meeting sensitive deadlines in a fast-paced environment with a personal commitment to producing the highest quality work and providing extraordinary customer service; demonstrated ability to effectively follow through on assigned projects.

5.      Proficient in operating a standard desktop and Windows-based computer system, including but not limited to, Microsoft Word and Excel, intranet and computer navigation.  Ability to use other software as required while performing the essential functions of the job including EPM and EHR systems.

6.      Excellent communication skills in both written and verbal forms, including proper phone etiquette.

7.      Ability to work collaboratively in a team-oriented environment; courteous, professional and friendly demeanor.

8.      Ability to work effectively with various levels of organizational members.

9.      Good organizational and time management skills to effectively juggle multiple priorities and time constraints in a fast-paced environment.

10.   Ability to exercise sound judgment and problem-solving skills.

11.   Ability to maintain any organizational information in a confidential manner.

12.   Successful completion of IHA competency-based program within introductory and training period.

13.   Ability to work overtime hours as scheduled.

 


 
MINIMUM PHYSICAL EXPECTATIONS:

 

1.      Physical activity that often requires keyboarding, filing and phone work.

2.      Physical activity that often requires extensive time working on a computer and sitting.

3.      Physical activity that sometimes requires walking, bending, stooping, reaching, and/or twisting.       

4.      Physical activity that sometimes requires lifting, pushing and/or pulling under 30 lbs.

5.      Specific vision abilities required include close vision, depth perception, peripheral vision and the ability to adjust and focus.

6.      Manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment.

7.      Must hear and speak well enough to conduct business over the telephone or face to face for long periods of time in English.

 

MINIMUM ENVIRONMENTAL EXPECTATIONS:

 

This job operates between working in a typical office environment which involves frequent interruptions and interaction with people which can be stressful at times.

 



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