The Mayfield Clinic has long been recognized for its commitment to the people who work here. Mayfield challenges associates to exceed the expectations of the patients and referring physicians we serve, and empowers them with the resources to do so.
The Mayfield Experience
Mayfield seeks the brightest and most qualified individual for each position it fills. Associates are challenged to continuously improve services and processes in which they are involved. Our physicians are some of the most respected specialists in their fields, and they demand excellence on a daily basis. The successful associate is motivated by this drive, and is rewarded for demonstrated quality, commitment to excellence, follow through, and teamwork. Each associate must commit to the mission and core values of the Mayfield Clinic.
What you can expect from Mayfield
Our associates enjoy pleasant work environments and flexible work schedules, competitive salaries and benefits, robust profit sharing/401k retirement planning. Mayfield provides recognition and rewards programs, associate activities and honors programs, and generous holiday/vacation schedules. Mayfield conducts associate satisfaction surveys every 3-5 years and employs action teams to respond to any issues or problems identified during this process.
Reports To: Vice President of Finance & CFO
- Perform management and related activities for the coding and compliance functions of Mayfield Clinic, Inc.
- Help develop and maintain a corporate culture that supports the mission and values of the Mayfield Clinic.
- Manage the Hospital Services (HS) department to ensure accurate and timely billing of all hospital and facility services, including surgeries, minor procedures and E&M.
- Manage the associates in HS including:
(1) recruitment, interviewing and hiring,
(2) orientation and training and
(3) timely performance reviews and coaching and/or termination as needed.
- Perform and/or coordinate periodic internal audits of surgical cases and E&M for correct coding, accurate charge entry, and required documentation. Annually review provider E&M coding patterns and report to provider and VP of Finance.
- Serve as coding and compliance resource to physicians, managers, Hospital Services and Revenue Cycle Management, providing formal and informal education, as appropriate.
- Serve as resource to Reimbursement Analysts (Revenue Cycle Management), providing tools, education and assistance, as needed, to ensure effectiveness and efficiency with appeals process.
- Maintain compliance database.
- Coordinate periodic coding audits of E&M, surgical and other services.
- Assist Compliance Officer in updating and maintaining the corporate compliance plan providing compliance training as needed.
- Manage the Perfect Serve charge capture process and provide or coordinate training for new providers.
- Coordinate with Human Resources to manage compliance training for all associates (including physicians and APPs) using Medtrainer and/or other online applications.
- Monitor policies and procedures to ensure accurate and complete billing of all services. Develop new forms, policies and processes as needed. Monitor statuses in practice management system to ensure services are billed timely.
- Perform or coordinate inpatient billing orientation and training of new physicians/providers regarding coding, documentation and compliance. Assist with office E&M orientation and training, as needed.
- Assist VP of Finance with special projects as requested
- Update CPT, ICD10, HCPCS, RVUs and quality codes in billing system annually. Update all billing documents for any code changes annually. Update EMR Case Categories as necessary.
- Create and maintain all coding edits for the practice management system (i.e. ACE).
- Review and update HIPAA policies and forms, as necessary.
- Manage reporting and/or monitoring of government and private initiatives on quality, reimbursement, etc. (e.g. MIPS, Open Payments, Physician Compare).
- Lead ongoing Compliance Committee and manage all Committee related activities.
- Respond to payer audit requests, reviewing and/or compiling chart documents to be sent.
- Develop and maintain online ABN forms library. Provide education on use of ABNs as necessary.
- Monitor payer medical policies and provide education to physicians as necessary.
- Minimum of five years' work experience, with at least two years surgical coding experience
- Bachelor's degree required in Healthcare, Finance or Accounting
- CPC or other coding certification preferred
- Skilled in CPT and ICD-10 coding for physicians
- Knowledge of regulations impacting compliance, including Medicare and HIPAA
- Word and Excel proficiency
- Strong oral and written communications
Hand Movement, including repetitive motions, grasping, holding and finger dexterity. Reading, Writing and Hand-Eye Coordination. Vision, including color distinction, and visual inspection. Hearing, Talking, Sitting for long periods of time, Lifting up to 10 pounds, Bending, Reaching.
Inside average office environment. Average office noise levels. Controlled temperature. No personal protective equipment required.
Qualified candidates should send their resume to firstname.lastname@example.org, fax to 513-569-5279 or mail to the HR Department, 3825 Edwards Road - Suite 300, Cincinnati, OH 45209. Please indicate that you are applying for the Mgr. Coding & Compliance position.
Location: Rookwood Exchange
Reports To: Jene Skelly, Director Compliance and Finance
- Help develop and maintain a corporate culture that supports the mission and values of Mayfield Clinic.
- Code and bill surgical cases accurately and timely. Provide direction to the other coders and serve as a coding resource to the coders, physicians, and others as needed.
- Bill inpatient E&M and other procedures accurately and timely
- Communicate timely with physicians on inpatient billing and documentation questions and issues as needed.
- Provide direction to the other coders and serve as a coding resource to the coders, physicians, and others as needed.
- Assist management in monitoring policies and procedures to ensure accurate coding and billing of all services, and in developing new forms, policies and processes as needed.
- Perform monthly reconciliation of all surgical and pain procedures cases per the facilities to Mayfield billing records.
- Perform monthly review of Hospital Services coded encounters for accuracy and opportunities for continued education.
- Resolve questions and issues in the Hospital Services CPS visit owner.
- Assist Credentialing Specialist with case and CPT volume reports, as needed.
- Monitor New and In Progress statuses for both office and facility locations. Work with coders and operations leads or managers to resolve tickets that are older than 1 week.
- Assist with coordination of internal and/or external coding audits.
- Lead in the orientation and training of new physicians/providers in the areas of surgical coding, documentation, compliance, and E&M coding.
- Provide coding assistance to secretaries for surgery pre-certification and predetermination.
- Prepare periodic reports (e.g., Lag Days, Missing Surgical Data), as required by management.
- Assist Revenue Cycle associates with questions and appeals related to coding.
- Communicate with physicians on general inpatient coding issues quarterly, or more frequently if requested by the physician.
- Contribute to team effort by performing other duties as assigned.
- High School Diploma required; some college or technical training preferred
- CPC or other coding certification desirable
- Minimum five years work experience, with at least two years surgical coding experience
- Knowledge of CPT and ICD-10 coding for physicians
- Word and Excel proficiency
- Strong oral and written communication skills
- Excellent problem solving and decision making skills
- Exceptional attention to detail
- Desire and ability to work in team environment
Qualified candidates should send their resume to email@example.com, fax to 513-569-5279 or mail to the HR Department, 3825 Edwards Road - Suite 300, Cincinnati, OH 45209. Please indicate that you are applying for the Surgical Coder position.