Geode Health is a rapidly growing, national provider of outpatient mental health services. Our mission is ' To empower our patients to live healthier, more rewarding lives through access to exceptional care tailored to their needs .'
The Compliance Audit and Training Specialist is responsible for performing audits as associated with the Compliance Work Plan to review coding and documentation related to mental health outpatient professional charges. The role reports to the Director of Compliance and will serve as an integral part of the ongoing quality of clinical documentation and provider education. Key Responsibilities: Responsible for auditing of clinical documentation to ensure appropriate selection of evaluation and management codes, CPT and modifiers as well as appropriate sequencing of diagnostic codes. Performs validation reviews for coding quality, accuracy, and compliance. Provides written feedback and/or one on one recommendations for providers or other coding staff related to documentation and coding guidelines. Prepares audit reports for presentation. Abides by the Standards of Ethical Coding and adheres to official coding guidelines. Responsible for researching education topics and/or opportunities for providers on coding and reimbursement issues and updates and completing administrative activities required to deliver education. Conduct continuous audits based on a pre-determined schedule, as well as on an as needed or requested basis. Apply judgment to ensure compliance with coding documentation and billing laws, regulations and guidelines to safeguard against fraud waste and abuse. Assist with the development and presentation of communications, for providers resulting from provider audit findings, including billing, coding and medical record documentation. Communicate documentation, coding, and charge errors and trends found in audits to Team Lead and/or Director of Compliance. Serve as onboarding peer for new providers and assist with compliance education and training. Assist with preparation for external audits and coordinate information requests. Track deliverables Keep up to date on current laws, regulations and guidance's applicable to mental health outpatient coding, billing and medical documentation. Participate in educational programs and training meetings; attend other meetings as requested and/or required. Assist with special projects as directed. Maintain strictest confidentiality. Perform other duties as assigned/requested. Qualifications/Skills: Bachelor's degree or equivalent education and experience 3-5 years coding and/or auditing experience working in mental health or behavioral health specialties preferred. A nationally recognized coding credential: CPMA, CPC, COC, CCS, CCS-P, RHIA or RHIT Excellent oral and written communication skills to effectively interact with and communicate with providers. Strong experience working with PowerPoint, Excel, and Adobe. Understanding of all or a combination of ICD-10, CPT, medical terminology and HIPAA Compliance Ability to consistently engage and build relationships with internal and external partners. Self-motivated and resourceful with the ability to multi-task and meet deadlines under time pressures. At Geode Health, we offer: Competitive compensation Flexible schedule In-person and virtual patient visits Comprehensive admin support (front office, accounting, finance, payroll, HR, etc) Professional development opportunities Clinical community, support, and leadership Medical, dental and vision benefits Life insurance Short and long-term disability Paid vacation and holidays Matching 401k plan State of the art technology Why work for Geode Health? At Geode Health, we take our commitment to patients and providers seriously. We focus every day on how to help patients across the United States get the best possible mental health care available. To achieve this, we focus on ensuring our providers have unmatched support and resources so that they can focus on providing great care. We are backed by KKR, a leading private equity firm with the experience and mission alignment to truly make an impact. Joining Geode Health will put you on the front-end of a rapidly growing movement to increase access and improve outcomes for mental health patients and providers across the nation.
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Geode Health is an Equal Opportunity Employer. We respect and seek to empower each individual and support the diverse cultures, perspectives, skills and experiences of our workforce. #J-18808-Ljbffr
