Coding Compliance Specialist jobs in South Bend, IN

POSITION: Manager, Coding & Compliance

DEPARTMENT: Revenue Cycle Management
FLSA STATUS: Exempt
REPORTS TO: Sr. Manager, Revenue Cycle Operations & Integration

WHO WE ARE:

AC3 was founded by practicing oncologists along with data and practice analytics experts to support the business side of medicine. Our mission is to modernize and digitize the delivery of healthcare and improve countless lives along the way.

We combine the power of big data technology and people to enable easier frontline decisions about complex problems. AC3 offers its employees an exciting, fast-paced, and challenging work environment. To learn more about AC3, visit us at www.ac3health.com.

COMPANY MISSION: To simplify healthcare and reduce the cost of care, empowering care givers to focus on what matters most – fighting cancer.

POSITION SUMMARY: AC3 is searching for an experienced Certified Manager of Coding & Compliance for our growing multi-specialty coding services. The manager will be responsible for developing & overseeing a team of coders, conducting billing & coding audits, leading coding education efforts, & identifying process improvement initiatives. They will work cooperatively as a team with revenue cycle, client practices, and management. They will provide courteous and professional assistance with coding questions from physicians, clinical team members, and other departments. The successful candidate for this role must have exceptional communication, organizational skill, and detailed-oriented.

Essential Function and Job Responsibilities

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Manages coding & compliance education and auditing activities, internally & externally.
• Provides direction, prioritization, & resource allocation for the coding team to ensure target metrics (e.g. avg. charge lag days, clean claim rates, accuracy rates, etc.) are achieved.
• Analyzes clinical documentation, billing system workflows/rules, & data to optimize billing and coding operations in numerous EMR & PM Systems.
• Remain current on coding and billing regulations as well as any CPT, ICD-10, or HCPCS updates.
• Lead all client education initiatives as AC3’s subject matter expert
• Ensures compliance with medical coding policies and guidelines; understands the application of each code set.
• Proactively retrieves, reads, and applies updated LCD/NCD policies, reimbursement policies, & medical policies & guidelines.
• Deep understanding of insurance reimbursement requirements & contractual language (e.g. bundling, timely filing, non-billable, etc.)
• Identifies and reports any fraud, waste, or abuse concerns.
• Familiarity with state specific rules/regulations, operates in a multi-state environment.

POSITION REQUIREMENTS

• Certified Professional Coder (CPC) through AAPC, required.
• Certified Professional Medical Auditor (CPMA) or equivalent, preferred.
• High School Diploma or equivalent required.
• At least 5 years of professional fee coding experience preferred. Minimum of 3 years experience working & performing in a leadership role required.

• Working knowledge/experience in Practice Management Systems (G4/Centricity & Unlimited Financials platforms preferred)
• Working knowledge/experience in EMR Systems (Aria, Athena, UroChart, Mosaiq preferred)

• Excellent oral & written communication skills, effective presenter.
• Demonstrates knowledge and competence in CPT, HCPCS, ICD-10, POS, and modifiers.
• Accurately code/bill charges to the best of your ability without fraudulence.
• Knowledge of anatomy and medical terminology.
• Excellent communication and organizational skills with the ability to work in a fast-paced environment; prioritize tasks and workloads.
• Performs other duties as assigned.

This is a remote/hybrid position with the expectation of travel to meet the needs of the position. Work is completed in a general office environment, sedentary in nature but may require standing and walking for up to 10% of the time. The work environment is favorable with adequate lighting and temperature, and no hazardous or unpleasant conditions caused by noise, dust, etc. Must be able to operate standard office equipment and keyboards.

Why Work at AC3?

When you become an AC3 Team member, you can expect ongoing training, support, and a work culture like no other. We offer our Full-Time Team Members medical, dental and vision health and wellness benefits, along with employer paid life insurance, long and short-term disability policies. Because our team’s health and wellness are our priority, we start new hires off with an above average paid time out plan and offer a comprehensive wellness program, including onsite biometrics and ongoing mental and physical wellness support. We also provide all Team Members with access to company sponsored financial wellness counselors, employee assistance services and the opportunity to enroll in our company-matched, 401k plan.

Come join our Winning Team!