Certified Coding and Compliance Specialist

Preferred Primary Care Physicians (PPCP) is currently recruiting for a Certified Coding & Compliance Specialist to work out of our Central Administrative Office located at: 701 Technology Drive, Suite 150, Canonsburg, PA, 15317. This is a full-time hourly position with a highly competitive starting wage and fantastic benefits! The successful candidate is REQUIRED to have 4 or more years of experience in medical coding, billing, auditing and Compliance. Extensive knowledge of third-party payer coding, billing, and documentation compliance regulations (ICD10-CM, CPT, Modifiers, etc.). Successful candidate must hold at least an Associate's Degree and be a current Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC)

Come join the PPCP Team and get a highly competitive starting wage, fantastic health benefits including medical, dental, vision, and one of the best 401k retirement plans in the medical field. Great schedule of Monday-Friday daylight hours!!

Primary Purpose of the Certified Coding & Compliance Specialist:

The primary duties of this Certified Coding and Compliance Specialist will be to review and audit all pertinent documentation in the medical record. The position is responsible for evaluating the level of acuity, procedures performed, billable supplies, and diagnosis to substantiate medical necessity. Also, this position will ensure coding/documentation adheres to appropriate state and federal regulations and/or standard review and make recommendations to maximize reimbursement.

Certified Coding & Compliance Specialist Responsibilities:

• Conduct PPCP wide auditing and monitoring to ensure Coding and medical records adequately support medical necessity.
• Validate the ICD-10, and CPT appropriateness to ensure consistency and efficiency in claims processing, data collection, and quality reporting.
• Communicate and educate providers of audit findings.
• Prepare written audit results, including recommendations for improvement and Compliance with state and federal regulations.
• Advise leadership on regulatory requirements for coding documentation and billing to ensure services are submitted according to payor guidelines and related regulations.
• Maintain current knowledge and understanding of regulatory trends and changes in coding policy and reimbursement methods.
• Conduct post-audit compliance training sessions for physicians and non-physician practitioners as audit results dictate. These training sessions will include, but are not limited to, provision of education specific to the issues found on audit and will be largely based on the documentation, Coding and billing rules as set forth by CMS and other relevant Federal and State regulatory agencies.

Qualifications:

• High School or GED equivalent. Associate degree or higher or comparable technical school diploma is required.
• 4 or more years of experience in medical coding, billing, auditing and Compliance. Extensive knowledge of third-party payer coding, billing, and documentation compliance regulations (ICD10-CM, CPT, Modifiers, etc.).
• Knowledge of coding/classification systems appropriate for office setting E/M codes.
• Knowledge of key revenue cycle processes and clinical documentation is strongly preferred.
• Proficiency with associated technology solutions such as Microsoft Excel, Word, and PowerPoint is required.
• Must be able to demonstrate a high degree of professionalism, enthusiasm and initiative daily.
• Must have strong interpersonal, organizational, and analytical and communication skills.
• Ability to work in a fast-paced environment.
• Must have ability to manage multiple tasks and projects and develop relationships within the department and with office locations.
• Attention to detail is critical to the success of this position.
• Excellent planning, communication, documentation, organizational, analytical, and problem-solving abilities.

Licensure, Certifications, and Clearances:

Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC)

About Us:

At Preferred Primary Care Physicians, preferred health care is simply our standard. Our practice was established in 1995 when a group of dedicated physicians in the South Hills came together for one common purpose: to provide the highest quality care to their patients. Their ingenuity and expertise laid the foundation for our independently owned practice, which now operates out of more than 20 locations in the greater Pittsburgh area. Our elevated level of service is supported by our team-based approach, comprehensive clinical programs, and state-of-the-art outpatient centers. From providing general primary care to managing chronic conditions, we give all of our patients the preferential treatment they deserve.

Come join the team and enjoy a very competitive employee benefit package including medical, dental, vision, company paid life insurance, and 401k with competitive match.

Please visit our website www.ppcp.org for more info about our company.

EOE