Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Pay Range:

Scheduled Weekly Hours:

Position Overview

*Please note - while remote, we are only considering candidates in New Jersey, Pennsylvania, and Alabama*

Serves as the main resource to provide direct communication on a regular basis with Capital Health Medical Group (CHMG) Physicians, Nurse Practitioners, Advanced Nurse Practitioners, and Physician Assistants to provide feedback on documentation as it relates to procedure coding. Provides direct supervision and monitoring of professional coding staff activities to promote compliance with industry and government regulations. Facilitates compliant coding of professional procedural services using ICD10-CM diagnostic and Current Procedural Terminology procedure coding for all employed physicians and practitioners of CHMG. Supervises and maintains productivity levels for internal and external professional coding staff. Supervises the monitoring and delegation of all prospective claim edits from the billing system to ensure timely submission and payment for procedure coding. Coordinates education and correspondence with physicians and practitioners regarding procedural coding services.

MINIMUM REQUIREMENTS
Education: High school diploma or equivalency. Certified Professional Coder (CPC) or Certified Coding Specialist-Physician-based (CCS-P) required. Physician coding certification.
Experience: Three years professional procedure coding experience.
Other Credentials: CPC
Knowledge and Skills: Excellent interpersonal, organizational, verbal and written communication skills. Self-motivated and able to work independently with minimum supervision. Strong knowledge of industry guidelines and laws for professional coding. Possesses research and analysis skills.
Special Training: Proficient with with Microsoft applications to include Outlook, Word, Excel, PowerPoint or Access. Medical Terminology, Anatomy and Physiology, or Pathophysiology knowledge. Ability to assess and provide coding education plans using a variety of methods to professional coding staff.
Mental, Behavioral and Emotional Abilities: Ability to work in a collaborative manner with coding staff, practice staff and physicians to determine team needs and to prioritize workflow. Ability to multi-task/manage various projects and programs.
Usual Work Day: 8 Hours
Reporting Relationships
Does this position formally supervise employees? Yes

If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.

ESSENTIAL FUNCTIONS
Provides direct supervision, support, education and direction to physician fee coding staff as it relates to time management, delegation of workflow tasks and responsibilities, knowledge of industry guidelines, laws and regulations.
Performs internal quality assessment reviews on professional coding to ensure compliance with national coding guidelines and Capital Health's policies for complete, accurate and consistent coding which results in appropriate reimbursement and data integrity.
Proactively troubleshoots documentation and/or communication issues and communicates directly with members of CHMG to provide feedback and education to accurately capture required documentation to support revenue integrity.
Monitors and educates professional coding staff on process of provider documentation review to ensure revenue integrity for all procedural services.
Supervises and disseminates appeals process resulting from third party payers to support revenue integrity for services performed by CHMG physicians and practitioners.
Researches coding and reimbursement issues and implements corrective measures to resolve them. Regularly reports those findings to management, physicians and coding staff as appropriate.
Ensures all professional coding staff maintains expected quality level for coding procedures for CHMG physicians and practitioners.
Provides management with various statistical reports on professional coding compliance issues, internal and external quality assurance results and activities, performance improvement activities and other statistical information as required or requested.
Ensures professional coding staff maintains a level of expertise by attending continuing education programs.
Provides direct supervision, support, education and direction to physician fee coding staff as it relates to time management, delegation of workflow tasks and responsibilities.
Performs analysis and trending of billing system issues to achieve optimal coding accuracy and compliance of CHMG physicians services.
Adapts to changing department demands required for higher departmental efficiency.

PHYSICAL DEMANDS AND WORK ENVIRONMENT
Frequent physical demands include: Sitting , Standing , Walking , Carry objects , Wrist position deviation , Keyboard use/repetitive motion

Occasional physical demands include: Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Pinching/fine motor activities

Continuous physical demands include: Talk or Hear

Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs.

Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Color Discrimination, Accurate Depth Perception, Accurate Hearing
Anticipated Occupational Exposure Risks Include the following: N/A

This position is eligible for the following benefits:

• Medical Plan

• Prescription drug coverage & In-House Employee Pharmacy

• Dental Plan

• Vision Plan

• Flexible Spending Account (FSA)

• Healthcare FSA

• Dependent Care FSA

• Retirement Savings and Investment Plan

• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance

• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance

• Disability Benefits – Long Term Disability (LTD)

• Disability Benefits – Short Term Disability (STD)

• Employee Assistance Program

• Commuter Transit

• Commuter Parking

• Supplemental Life Insurance

• Voluntary Life Spouse

• Voluntary Life Employee

• Voluntary Life Child

• Voluntary Legal Services

• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance

• Voluntary Identity Theft Insurance

• Voluntary Pet Insurance

• Paid Time-Off Program

The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level.

The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.