Join Chimes - and go further to help others go far! Chimes is a not-for-profit organization that assists people with intellectual and behavioral challenges to achieve their fullest potential.Our vast array of services - educational, employment, vocational, residential, habilitative and behavioral health - are delivered through a network of national and international affiliates. This allows us to take a comprehensive, holistic approach to improving the lives of every person we serve - those who receive and reap the benefits of our innovative, responsive solutions.Compensation: $65,000-$68,000PRIMARY JOB FUNCTION(S):
Independently performs scheduled audits especially audits that involve receiving medical codes etc, required by the work plan and unplanned investigations
Provides compliance guidance to personnel
Answers questions and provides guidance on coding and/or billing issues
Works with team to determine appropriate corrective action when necessary
Monitors and respond to certain regulatory request
Represents the Compliance Department on various committees as requested
Generates narrative and quantitative reports concerning all activities.
Prepares information required for designated meetings.
Contributes to a work atmosphere in a manner which is positive, enthusiastic, respectful and courteous.
Ability to follow detailed instructions.
Uses technology for the completion of specified job duties and assists staff in learning to use the technology.
Attends work regularly according to assigned work schedule and in accordance with Agency policy.
Attends and participates in in-service training, staff meetings, and other activities to facilitate professional development.
Works cooperatively with others including staff, supervisors, administrators, co-workers, individuals served, community professionals, customers, vendors, and the public.
Assist with plans of correction for OHCQ site visit reports within applicable time frame(s) and ensure completion of corrective actions.
Provides scheduled staff training as determined by the training department.
Works a flexible schedule consisting of evening hours as needed.
Assumes other administrative duties, responsibilities and special projects as assigned
Ability to differentiate between CMS-1500 and UB-04 claims
Knowledge of Substance Abuse and Mental Health CPT and revenue codes
Strong familiarity with major commercial insurance plans and policy types, specifically BCBS, Aetna, Cigna, Johns Hopkins, United Healthcare, and Medicaid
Advance proficiency in Microsoft Office Suite, particularly Excel
Will be working through ICD9 and ICD10 codes
Must have strong working knowledge of Medical Terminology
REQUIREMENTS:Obtain Certified Investigator certification within 90 days of hireDriver's licenseEDUCATION:BA DegreeMedical Coding Certification required (CPC OR CPC-A)EXPERIENCE:
Professional level of knowledge of billing practices and procedures
In depth knowledge in the areas of Medicare and Medicaid, and commercial insurance billing regulations
Minimum of 4 years' experience in a healthcare compliance program, however provider payment and healthcare coding experience may be used toward experience requirement
Familiarity with the healthcare regulatory environment
Knowledge of basic coding and healthcare licensing/accreditation standards is required
Knowledge of multi state and federal laws and regulation with affect compliance operations
NOTE: At the discretion of the Personnel Officer, additional related experience and/or education may be substituted in lieu of the requirements specified under Education and Experience.What's in it for you? Total Rewards (For Full-Time Employees = >30 hours/week):
Medical, Dental, and Vision Insurance
Flexible Spending Accounts
Life Insurance
Disability Insurance
Paid Time Off
403(b) with Company Match
Transportation Subsidy
Employee Recognition Programs
Referral Bonus opportunities
And More!
Want to learn more?To learn more about Chimes, and how you can achieve personal and professional growth within a purpose-driven organization, visit us at: https://chimes.org/Careers. #cmd410
