Talent.com
Pro Fee Coding Spec - PFS Physician - Miamisburg - FT/Days
Pro Fee Coding Spec - PFS Physician - Miamisburg - FT/DaysKettering Medical Center Network • Miamisburg, OH, United States
Pro Fee Coding Spec - PFS Physician - Miamisburg - FT / Days

Pro Fee Coding Spec - PFS Physician - Miamisburg - FT / Days

Kettering Medical Center Network • Miamisburg, OH, United States
30+ days ago
Job type
  • Full-time
Job description

Overview

Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.

Campus Overview

Kettering Health Miamisburg

  • Serving the residents of Warren, Butler, and Southern Montgomery counties for over 40 years.
  • Kettering Health Miamisburg, formerly Sycamore Medical Center, is a full-service hospital located minutes west of the Dayton Mall on Miamisburg-Centerville Road off I-75 in Miamisburg, Ohio.
  • The cornerstone services for KH Miamisburg have been Bariatric surgeries and Orthopedic care.
  • Expanded services include emergency care, sleep center, mammography, breast MRI, cardiac catheterization lab, wound center and DEXA scanning.
  • 142 bed facility
  • Awarded with 100 Top Hospital by IBM Watson Health for the 10th time in 2019.
  • In 2020, KH Miamisburg received an "A" from the Leapfrog Group, a national patient safety watchdog, ranking among the safest hospitals in the United States.
  • Accredited by the American College of Emergency Physicians as a Level 3 Geriatric Emergency Department.
  • KH Miamisburg received several awards from Healthgrades :
  • Outstanding Patient Experience Award (2017-2019)
  • America's 100 Best Hospitals for Prostate Surgery Award (2020)
  • Joint Replacement Excellence Award (2020)

Responsibilities & Requirements

This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance and EPIC WQ Reconciliation.

KPN Pro Fee Coding Specialist

Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines.

  • Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
  • Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10
  • Reviews and researches pending and denied claims pertaining to professional fee coding, CMS NCCI edits, and / or medical necessity requirements [CMS LDC / NCD and / or payer policy]
  • Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits
  • Corresponds with providers on pending claims to facilitate resolution
  • Responsible for participating in departmental goals, KHN mission and implemented KHN / KPN policies
  • Communicate appropriately with providers, leaders, and staff
  • Researches and resolves concerns timely
  • Knowledge and Skill :

    CPT, HCPCS, Modifiers, ICD-10, and CMS NCCI Edits

    Medical Terminology and Anatomy & Physiology

    Computer and EPIC Applications

    Excellent verbal and written communication skills

    Abilities :

    Charge Review WQ [Edits]

  • Reviews, researches and responds to Charge Review WQ edits pertaining to coding, CMS NCCI edits, and / or medical necessity requirements to facilitate resolution.
  • Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and / or medical necessity requirements to facilitate resolution.
  • Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
  • Claim Edit WQ [Edits]

  • Reviews, researches and responds to Claim Edit WQ edits pertaining to coding, CMS NCCI edits, and / or medical necessity requirements to facilitate resolution.
  • Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and / or medical necessity requirements to facilitate resolution.
  • Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
  • Follow Up WQ [Denials]

  • Reviews, researches and responds to Follow Up WQ edits pertaining to coding, CMS NCCI edits, and / or medical necessity requirements to facilitate resolution.
  • Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and / or medical necessity requirements to facilitate resolution.
  • Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
  • Departmental Responsibilities

  • Responsible for participating in departmental goals, KHN mission and implemented KHN / KPN policies
  • Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits
  • Follow procedures pertaining to position
  • Researches and resolves concerns timely
  • Preferred Qualifications

    Educational Requirements :

    High School Diploma or equivalent

    RHIT, RHIA, CCS, CCS-P, CPC or eligible specialty certification

    Prior experience in professional fee coding / billing

    Create a job alert for this search

    Physician • Miamisburg, OH, United States

    Related jobs
    Physician Gastroenterology - Competitive Salary

    Physician Gastroenterology - Competitive Salary

    Tenet Healthcare • Dayton, OH, US
    Full-time
    BC / BE Gastroenterologist to join an established practice in Dayton, Ohio.This is a fantastic opportunity to practice high quality clinical care in a large, collegial practice.General GI Practice; ...Show more
    Last updated: 30+ days ago • Promoted
    Pro Fee Coding Spec - PFS Physician - Miamisburg - FT / Days

    Pro Fee Coding Spec - PFS Physician - Miamisburg - FT / Days

    Kettering Health Network • Miamisburg, OH, United States
    Full-time
    Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with hig...Show more
    Last updated: 30+ days ago • Promoted
    Medical Payment Poster

    Medical Payment Poster

    HealthSource of Ohio • Loveland, OH, United States
    Full-time
    Centerprise is seeking to hire a Medical Payment Poser.This is a hybrid-remote position that requires up to 90-days in office training. After training, may be eligible to work a hybrid-remote schedu...Show more
    Last updated: 18 days ago • Promoted
    Cardiology - Noninvasive Physician

    Cardiology - Noninvasive Physician

    ProLocums • Dayton, OH, USA
    Full-time
    Cardiology - Noninvasive Physician at ProLocums summary : .The Cardiology - Noninvasive Physician position involves providing full-time clinical services at a leading adult Level I trauma center in O...Show more
    Last updated: 30+ days ago • Promoted
    Physician / Oncology / Ohio / Locum Tenens / Locums / Oncology / Job / Ohio Job

    Physician / Oncology / Ohio / Locum Tenens / Locums / Oncology / Job / Ohio Job

    MD Staff, LLC • Dayton, OH, US
    Full-time
    Seeking for an Oncologist to join an outpatient practice in Ohio.The schedule will be Monday through Thursday from 8 to 4 : 30 with inpatient consult coverage. If you are interested in hearing more ab...Show more
    Last updated: 30+ days ago • Promoted
    Physician / Ohio / Locum or Permanent / Dayton Area Urologist Opening Job

    Physician / Ohio / Locum or Permanent / Dayton Area Urologist Opening Job

    Honor Medical Staffing • Dayton, OH, US
    Permanent
    This well-known healthcare system in southwest Ohio is in search of a full-time Urologist in the Dayton suburbs.Here you'll join an established practice that is adding this position due to increase...Show more
    Last updated: 30+ days ago • Promoted
    Hematology / Oncology Physician

    Hematology / Oncology Physician

    Archway Physician Recruitment • Middletown, OH, USA
    Full-time
    Hematology / Oncology Physician at Archway Physician Recruitment summary : .A BE / BC Hematology / Oncology Physician is sought for a full-time position in Middletown, Ohio, offering best practices in canc...Show more
    Last updated: 30+ days ago • Promoted
    Physician Internal Medicine - Competitive Salary

    Physician Internal Medicine - Competitive Salary

    Dane Street • Dayton, OH, US
    Full-time
    ADA-compliant exam space to conduct.Medical Disability Examinations.Partnering with the Department of Veterans Affairs, you will help clear the exam backlog and ensure Veterans receive their earned...Show more
    Last updated: 25 days ago • Promoted
    Pricing Configuration Architect - NETWORX / Heavy SQL exerpeince must.

    Pricing Configuration Architect - NETWORX / Heavy SQL exerpeince must.

    CareSource • Dayton, OH, United States
    Full-time
    Configuration Architect is responsible for the definition, oversight, coordination and development of designs and processes along with related road maps and lifecycle management to provide custom c...Show more
    Last updated: 30+ days ago • Promoted
    Physician / Ohio / Locum Tenens / Progressive Health System In Ohio Seeking A Urologist Job

    Physician / Ohio / Locum Tenens / Progressive Health System In Ohio Seeking A Urologist Job

    The Curare Group • Dayton, OH, US
    Full-time
    Our client is seeking an additional Urologist to join a growing practice.This is an exceptional opportunity, affiliated with a progressive health system surrounded by dynamic and family-friendly co...Show more
    Last updated: 30+ days ago • Promoted
    Infectious Disease

    Infectious Disease

    Curare Group, Inc. • DAYTON, Ohio, US
    Full-time
    Infectious Disease physician job in Ohio : Top health system in southwest Ohio is growing and needing to add an Infectious Disease specialist to their busy practice. This comprehensive system has fi...Show more
    Last updated: 30+ days ago • Promoted
    Medical Records Specialist Home Health - Full-time

    Medical Records Specialist Home Health - Full-time

    Enhabit Home Health & Hospice • Sharonville, OH, United States
    Full-time
    Are you in search of a new career opportunity that makes a meaningful impact? If so, now is the time to find your calling at Enhabit Home Health & Hospice. As a national leader in home-based care, E...Show more
    Last updated: 18 days ago • Promoted
    Physician / Anesthesiology / Ohio / Permanent / Anesthesiologist Job

    Physician / Anesthesiology / Ohio / Permanent / Anesthesiologist Job

    ECHO Locum Tenens • Kettering, OH, US
    Permanent
    Echo Locum Tenens is a direct affiliate of Sound Physicians, offering priority scheduling ahead of other locum agencies.Enjoy flexible shifts with no minimum requirements, competitive pay, covered ...Show more
    Last updated: 30+ days ago • Promoted
    Internal Medicine Physician

    Internal Medicine Physician

    The Curare Group, Inc • Dayton, OH, USA
    Full-time
    Hospital employed Internal Medicine physician needed for medical group in Ohio, just a half hour north of Dayton.Outpatient only practice with flexible schedule and 1 : 4 call.Compensation is competi...Show more
    Last updated: 30+ days ago • Promoted
    Anesthesiology Physician

    Anesthesiology Physician

    National Staffing Solutions • Dayton, OH, USA
    Full-time
    Anesthesiology Physician at National Staffing Solutions summary : .We are seeking a dedicated and qualified TBI Physician to join our healthcare team, providing essential evaluations for patients exp...Show more
    Last updated: 30+ days ago • Promoted
    Physician Anesthesiology - Competitive Salary

    Physician Anesthesiology - Competitive Salary

    TeamHealth • Dayton, OH, US
    Full-time
    Work alongside a leader who is invested in your growth as a clinician! TeamHealth has an exciting opportunity for an anesthesiologist to join our team at Washington Township Medical Center (fo...Show more
    Last updated: 30+ days ago • Promoted
    Physician

    Physician

    Correctional Medicine Associates • Mason, US
    Full-time
    At CoreCivic, we do more than manage inmates, we care for people.CoreCivic is currently seeking .The Physician provides professional medical direction, oversight and direct patient c...Show more
    Last updated: 30+ days ago • Promoted
    Billing Invoicing Processor

    Billing Invoicing Processor

    Syntricate Technologies • Mason, OH, United States
    Full-time
    Job Title : Billing Invoicing Processor.Length of assignment : 6 months.Top 3-5 mandatory and / or minimum requirements.Knowledge of Medical Terminology : Understanding medical terms related to vision ...Show more
    Last updated: 26 days ago • Promoted