Physician Coding Quality Analyst
School of Medicine, Redwood City, California, United States
The Department of Psychiatry in the School of Medicine is seeking a Physician Coding Quality Analyst to join the Clinical Finance team to review medical documentation for appropriate CPT coding and documentation, and provide physician training as needed.
This position serves as the physician coding quality analyst for the Department of Psychiatry, the third largest department in the School of Medicine. This individual will be responsible for the development and delivery of training programs for faculty and staff to increase knowledge and skills related to the revenue capture cycle with the goal of maximizing revenue in a cost-effective manner that is in compliance with federal/state and payer-specific billing requirements. The analyst is responsible for the identification, analysis and recommendations for resolution of issues and outstanding problems pertaining to coding and charge capture. The individual will perform audits of documentation and coding of inpatient and/or outpatient professional fee services and will also be the Department's liaison with both the SHC and LPCH Professional Revenue Cycle group and School of Medicine Compliance.
SHC and LPCH Revenue Cycle/Information Systems (IS) Liaison
- This position represents faculty billing and is an advocate for efficient billing and procedures.
- This position will also be involved in our Clinical Outreach and ensure that all bills are accurately going through the SHC, SoM, LPCH billing cycle.
- Work with Compliance to ensure proper coding and results will be accurate and defensible.
- The primary role of this position is to continue to meet and train our Faculty of the latest CPT codes
- Perform audits of documentation & coding of inpatient and/or outpatient professional fee services;
- Analyze results & identify patterns, trends & variations in coding & documentation practices;
- Prepare reports of findings and recommendations for improvement for internal review and appropriate distribution (Department Chair, Division Chiefs, Section Chiefs, Clinic Chiefs, DFA, Director of Finance, etc.)
- Using the UHC Faculty Practice Solutions Center (FPSC) billing data, work closely with Department Clinical Finance team to identify divisions' and/or individual physicians' who are coding outside the norm;
- Identify operational deficiencies and target revenue enhancement opportunities.
EDUCATION & EXPERIENCE (REQUIRED):
- Track provider enrollment progress for new physicians. Ensure that all new physicians have a billing number on a timely basis;
- Coordinate updates of paper billing forms and work with IS to ensure that electronic billing forms incorporate the most up-to-date billing codes;
- Work with SHC and LPCH Revenue Cycle leadership and division faculty to improve efficiency and timeliness of billing sheet submission.
Bachelor's degree and five years of relevant experience, or combination of education and relevant experience.
Certification in either CPC, CPMA, and/or CEMCKNOWLEDGE, SKILLS AND ABILITIES (REQUIRED):
CERTIFICATIONS & LICENSES:
- Demonstrated ability to establish priorities, manage shifting priorities, and handle numerous time-sensitive projects with multiple deadlines.
- Ability to accomplish goals working through formal and informal channels, with diplomacy and tactfulness.
- Demonstrated creativity, problem solving, critical analysis, initiative, judgment and, decision-making skills.
- Demonstrated ability to develop and meet department goals.
- Demonstrated solid planning and organizational skills.
- Demonstrated experience working independently and as part of a team.
- Excellent interpersonal, written and oral communication skills.
- Strong relevant subject matter knowledge.
Certification in either CPC, CPMA, and/or CEMCDESIRED QUALIFICATIONS:
- Ability to apply critical thinking skills to coding policy interpretation and implementation
- Work independently; well-organized and able to set priorities with minimal direction
- Effectively communicate both verbally and in writing
- Strong PC skills; Excel, Word, PowerPoint and internet based program
To be considered for this position please visit our web site and apply on line at the following link: stanfordcareers.stanford.edu
Stanford is an equal opportunity employer and all qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by law.
- Constantly perform desk-based computer tasks.
- Frequently stand/walk, sitting, grasp lightly/fine manipulation.
- Occasionally use a telephone.
- Rarely lift/carry/push/pull objects that weigh 11-20 pounds.
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