Purpose: To conduct quality assurance reviews of physician coding and documentation, to verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered; and to provide education to staff and physicians regarding coding. Some duties and responsibilities include:

• Serve as a liaison to internal teams, stakeholders, business managers, senior leaders regarding activities and maintenance of the OSUP Compliance Program, to identify key areas for increased exposure; and develop and deliver education as needed.
• Collaborate with the managed care team to assist with value based payer initiatives, completion of forms and other validation requests.
• Assist in the development and ongoing maintenance of internal compliance policies and procedures for the OSUP Compliance Program. Collaborate with Compliance Educators, Specialists and leadership to express compliance concerns, issues and potential corrective actions to clinical chairs and administrators.
• Perform and/or coordinate all investigations of deficiencies resulting from the compliance reporting system or identified through the periodic audits. Coordinate and develop corrective and preventive action for areas identified as non-compliant.
• Conduct reviews of patient charts and medical record documentation for group faculty to determine accurate CPT, HCPCS procedure, professional supply codes and ICD-9-CM diagnosis codes, including by not limited to those mapped to an HCC at the encounter level.
• Collaborate with providers, peers and Compliance leadership to obtain additional information and provide further education on coding guidelines. Discuss audit results and provide recommendations where warranted.
• Keep current with medical compliance and reimbursement policies, such as medical necessity issues and correct coding issues. Maintains knowledge of CMS, state and federal coding rules and regulations. Effectively communicating updates.
• Develop and deploy tools, documentation, education materials and courses for providers and staff. Provide training and education on coding, documentation and other compliance issues to physicians, non-physician providers, and staff on an ongoing basis.
• Provide orientation training and education on coding, documentation, PATH and other compliance issues internally in Compliance and externally with physicians and staff.
• Conduct research on various compliance and documentation issues.
• Respond to and track third party inquiries regarding level of service coding by the physicians.
• Perform analyses using Qlik and other internal applications to assist in the development of comprehensive physician coding and compliance education to physicians, residents, APP’s and staff inclusive of all current regulations. Including, but not limited to using provider, division and department specific examples and incorporation of regulations and Hierarchy Condition Coding (HCC) initiatives.
• Assist in updating the OSUP Compliance Program.

• Certification as a CPC, CCS-P, RHIT or RHIA required or may hire on the condition of obtaining certification within first two (2) years of employment.
• Minimum of two years’ experience with coding and reimbursement for physician services.
• Skill in exercising initiative, judgment, discretion and decision–making to achieve organizational objectives.
• Skill in establishing and maintaining effective working relationships with physicians and other mid-level providers.
• Strong writing and presentation skills, solid interpersonal communication and facilitation skills are essential.
• Must have knowledge of physician auditing practices and an in-depth knowledge of CPT, ICD-9-CM diagnosis codes and HCPCS procedure and professional supply codes used for billing services provided by physicians and non-physician providers.
• Knowledge of third party fee profiles and reimbursement requirements is preferred.
• Must have knowledge of a variety of computer software applications in word processing, spreadsheets, database and presentation software (MSWord, Excel, Access, PowerPoint).
• A wide degree of creativity and latitude is expected.
• Work effectively with individuals and teams, able to contribute to and influence management.
• Must be able to interact and communicate with individuals at all levels of the organization.
• Analytical ability to gather and interpret data and develop, recommends, and implement solutions.
• Reports to the Director of Risk Management and Compliance, OSUP. Ongoing: Maintains current licenses and certifications.

Preferred: Associate or Bachelor degree in business or health related field as well as certified risk coder (CRC) certification. Prior experience with various systems such as EPIC, EncoderPro, or MD Audit; experience in academic medicine; and experience with data visualization tools such as Qlik.

OSU Physicians, Inc.

What is OSU Physicians all about?

• We believe that being engaged and sharing in a larger purpose at work is instrumental to the employee experience. “Tradition, determination, teamwork, purpose, compassion, community, pride, integrity”….these are just a few words that our employees use to describe what it feels like to embody the “Buckeye Spirit” and work for our organization.
• We strive to create environments where our colleagues and all those we serve feel empowered to share their full, authentic selves.
• Our over 60 physician practices embody the spirit of teamwork with passionate care for our patients and each other. Our teams are diverse in employees, thoughts, and ideas bringing the full spectrum of a collaborative culture to the big picture – TEAMWORK!
• OSU Physicians focuses on entire patient experience, from the minute they call in for an appointment, to being welcomed in the office, and then receiving quality, compassionate, thorough care from our physicians and the entire OSU Physicians healthcare team.

Sound like something you are seeking in your next career adventure? We invite you to keep reading.

What do we offer?

Benefits! It's all about choices. We know that having options and robust benefit plans are important to you. That's why here at OSU Physicians, we offer our employees a flexible, competitive benefit package. Full-time benefits start for individuals working a minimum of 30 hours per week, as well as some benefits available to employees working as little as 20 hours a week. Some of our excellent benefits options and perks include:

• Diverse and Affordable Healthcare Choices: Coverage begins on your First Day of Employment; includes Medical, Dental, Vision and Prescription Drug Programs.
• Outpatient clinic settings with day shift hours, Monday through Friday.
• Generous Paid Time-Off: Allowing a true work-life balance starting at 17 days per year and 11 paid holidays.
• Competitive compensation and career ladder opportunities
• Retirement Plan: Company contribution of 7.5% to your retirement plan in which you are fully vested from your first day of employment.
• Flexible Spending Accounts (Healthcare and Dependent Care).
• Paid Parental Leave Program
• Tuition Reimbursement Program