NAH reserves the right to make hiring decisions based on applicants' state of residence if outside the state of Arizona. NAH currently hires for remote positions in the following states:
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Coding Auditing & Compliance * Performs prospective and retrospective audits of professional fee coding (CPT, HCPCS, ICD-10-CM) across various medical and surgical specialties, including Evaluation and Management (E/M) services, procedures, and ancillary services. * Reviews medical record documentation to validate the accuracy and completeness of coded diagnoses and procedures, ensuring adherence to official coding guidelines (e.g., AMA CPT, CMS, ICD-10-CM Official Guidelines for Coding and Reporting), payer policies, and regulatory requirements (e.g., HIPAA, OIG work plans). * Identifies coding discrepancies, documentation deficiencies, medical necessity issues, and potential compliance risks. * Quantifies the financial impact of coding errors and identifies opportunities for revenue optimization while maintaining strict compliance standards. * Prepares detailed audit reports, including findings, recommendations, and corrective action plans. * Tracks and trend audit results to identify systemic issues, patterns of errors, and areas requiring focused education or process improvement. *Stays current with changes in coding guidelines, payer policies, and healthcare regulations, and integrates these updates into audit methodologies. |
Provider Education & Training: *Develops, customizes, and delivers comprehensive coding and documentation education sessions for physicians, APPs, and clinical staff, both individually and in group settings (e.g., department meetings, grand rounds). *Provides constructive, clear, and actionable feedback to providers on audit findings, offering practical guidance and examples for improving documentation and coding accuracy. *Creates and updates engaging educational materials, job aids, quick reference guides, and coding resources. *Serves as a subject matter expert for complex coding and documentation inquiries from providers and staff. *Collaborates with revenue cycle, compliance, clinical operations, and IT departments to ensure alignment of coding practices with organizational goals and system capabilities. * Monitors the effectiveness of educational interventions and adjusts strategies as needed to achieve desired outcomes. |
Quality Improvement & Policy Development: * Assist in the development, implementation, and revision of internal coding policies, procedures, and best practices. * Participate in compliance investigations related to coding and billing, providing expert analysis and recommendations. * Contribute to continuous quality improvement initiatives within the revenue cycle, clinical documentation improvement (CDI), and compliance programs. * Act as a liaison between clinical staff and billing/coding departments to facilitate effective communication and problem-solving. |
Compliance & Safety: *Responsible for reporting any safety-related incident in a timely fashion through the Midas/RDE tool; attends all safety-related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner. * Stays current and complies with state and federal regulations/statutes and company policies that impact the employee's area of responsibility. * If required for the position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates. * Completes all company mandatory modules and required job-specific training in the specified time frame. * Maintains confidentiality of all department, patient, and coding matters. * Stays current with medical terminology and human anatomy. * Meets industry standard measures of productivity and accuracy. |
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