Feb 13, 2019
The Clinical Quality Coding
& Education Analyst conducts pre-billing review of outpatient medical
records using ICD-10-CM and Current Procedural Terminology (CPT), Medicare
Advantage, and Centers for Medicare and Medicaid Services (CMS) coding and
reporting guidelines. Also responsible for;
, analyzing, and reporting clinical and billing documentation to support
diagnosis code assignment within Sutter Medical Foundation. Additionally this position also provides
education and operational support to clinicians and care center management to
support and improve physician and other clinician documentation for diagnosis
code reporting for Sutter Medical Foundation.
**** Limited Term, 30 weeks ****
**MINIMUM POSITION REQUIREMENTS:**
+ Requires a Bachelor’s degree in Business/Healthcare Administration, Finance, Nursing, or equivalent education/experience.
+ Certified Coding Specialist - Physician-based (CCS-P) or Certified Professional Coder (CPC) certification is required.
+ Requires at least 1 year of experience in a physician practice setting.
+ Experience required includes billing and/or coding for Medicare, Medi-Cal (Medicaid), managed care and other third party fee for service payers.
+ Auditing physician clinical documentation for both ICD-10 and CPT/HCPCS coding accuracy is required.
+ CPT-4, HCPCS and ICD-10-CM coding.
+ Government billing regulations, including; Medicare, Medicare Managed Care and Medi-Cal/Medicaid.
+ Medical Terminology.
+ Must have excellent written and verbal communication skills.
+ Microsoft Office including Word and Excel.
+ Ability to manage multiple assignments and priorities.
+ Knowledge of IDX and Epic software applications.
+ Data analysis skills.
+ Experience in Patient Financial Services helpful.
**Organization:** Sutter Medical Foundation - Central
**Employee Status:** Limited Term
**Employee Referral Bonus:** No
**Position Status:** Exempt
**Job Shift:** Day
**Shift Hours:** 8 Hour Shift
**Days of the Week Scheduled:** Monday-Friday
**Weekend Requirements:** Other
**Schedule:** Full Time
**Hrs Per 2wk Pay Period:** 80
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.