Auditing Project Lead jobs in Portland, OR

Lives Change Here! We are GROWING…Columbia River Mental Health Services provides comprehensive behavioral health and recovery services that transform the lives of children, adults and families in the communities of SW Washington. We are the largest and oldest not-for-profit provider of mental/chemical dependency treatment in southwest Washington with 200 employees and a history dating back to 1942.

Our Mission: Providing behavioral health and recovery services that transform the lives of children, adults, and families in the communities of SW Washington.

Starting Pay Range - $22.18 to $24.42/hour

Summary:

The Medical coding & compliance specialist is responsible in making certain that the documentation within the chart meets compliance with WAC, RCW, and other state and federal guidelines and that the codes assigned within the electronic health record (EHR) meet legal, federal and insurance regulations so that payments to services are easily obtained in a timely manner. The Medical Coding & Compliance Specialist will conduct routine audits of charts, which may include reviewing codes, documentation, and ensuring the evidence-based practices identified are showing properly within the note. The specialist will attend department and leadership team meetings and offer trainings to staff about how to properly document interactions and assist CPCO and billing staff in review of charts and codes for services offered.

Essential Job Responsibilities:

• Ensure that all charts have necessary paperwork to meet state and federal regulations
• Review client charts for accuracy of diagnoses and procedures
• Audit medical and behavioral health charts to ensure proper CPT codes, ICD10, HCPCS, documentation compliance, time documentation compliance, and interventions are properly documented, including evidence-based practices.
• Assist EHR and billing staff on identifying codes and recommending codes that could be utilized
• Assign appropriate codes to diagnoses or services
• Obtain any necessary clarification of information on the notes and charts to ensure correct coding and compliance with state and federal regulations
• Maintain department best practice productivity and quality standards.
• Provide training to staff on proper service selection, time documentation, and chart requirements to meet state and federal requirements
• Discuss coding questions with supervisor and billing staff and report unusual occurrences to Compliance officer.
• Run routine reports, develop tracking measures, and follow-up for department to ensure compliance with contracts, state and federal regulations and requirements.
• Auditing tasks as assigned
• Assist with any contract, state, insurance, or federal audits that occur
• Support the review and development of policies and procedures to meet contract, state and, and federal requirements.
• Provide back-up coverage for medical records for record release and uploading documents to meet quality standards, as requested.
• Perform EHR compliance reviews and investigations
• Receive and review court documents from Crisis Center on clients that are on LRA (Least Restrictive Alternative)/Conditional Release program
• Attend team and leadership meetings to be a resource on compliance requirements
• This position has access to consumer information. Therefore, the employee agrees to be bound by HIPAA regulations.
• Use various programs, including CareLogic and Methasoft, to perform tasks
• Use various HIPAA and 42 CFR Part 2 compliant request tools, such as DocuSign and NeoCertified email

Non-essential Job Functions:

• Assist CPCO in other duties as assigned.
• Provide training to staff on all of the above job functions, as needed
• Adhere to all departmental and agency policies.

Education, Licensing and Experience:

• Associates Degree required.
• Minimum of 2 Years experience with coding or auditing strongly preferred.
• Certification specializing in RHIT, CPC, CCS, HIM (Health Information Management)
• Experience working in a medical or behavioral health office setting required, with demonstrated understanding of standard insurance reimbursement methodologies.

Competencies, Knowledge, Skills and Abilities:

• Proven proficiency in data entry, keyboarding, email, Microsoft Office Suite, and agency management systems required.
• Excellent Medical terminology skills.
• Working knowledge of ICD-10, DSM-IV, CPT, and HCPCS universal coding systems.
• Knowledge of Correct Coding Initiatives (CCI) compliance regulations required.

Why Work Here?

CRMHS offers AMAZING benefits aside from health and wellness (medical/dental/vision etc.) Work life balance benefits: 12 paid holidays per year, including 3 paid floating holidays, and 24 days of PTO days accrued in the first year, and continues to grow from there! Career development: $325 annual allowance for career development and education with an additional 40 hours of paid time off for career development/education! And so much more!

PER COMPANY POLICY - ALL HEALTHCARE EMPLOYEES MUST BE EITHER COVID-19 VACCINATED / HAVE A MEDICAL/RELIGIOUS EXEMPTION.

IF EXTENDED AN OFFER OF EMPLOYMENT WITHIN OUR COMPANY, CANDIDATE MUST PROVIDE PROOF TO BE COMPLIANT (COVID VACCINE CARD/MEDICAL OR RELIGIOUS EXEMPTION) IN ORDER TO COMPLETE THE HIRING PROCESS.

EQUAL EMPLOYMENT OPPORTUNITY

Columbia River Mental Health Services is proud to be an equal opportunity workplace. We are committed to diversity and inclusion, and we seek applicants from all backgrounds to join our teams. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, age, national origin, disability, protected veteran status, gender identity, or any other factor protected by law. We encourage our employees to bring their authentic selves to work and do not tolerate discrimination at the workplace.

Experience

• 2 year(s): Coding & Auditing

Education

• Associates or better