Company: Steward Health Care
Location: Salt Lake City
Posted on: February 16, 2020
Location: Steward Medical Group - WestPosted Date:
1/28/2020About Steward Health Care SystemSteward Health Care is the
largest private, tax-paying physician-led health care network in
the United States. Headquartered in Dallas, Texas, Steward operates
35 hospitals in the United States and the country of Malta that
regularly receive top awards for quality and safety. The company
employs approximately 42,000 health care professionals. The Steward
network includes multiple urgent care centers and skilled nursing
facilities, substantial behavioral health services, over 7,900 beds
under management, and approximately 2.2 million full risk covered
lives through the company's managed care and health insurance
services.Steward Medical Group (SMG), Inc. is Steward's
multi-specialty group practice with over 4,500 employees including
over 1,800 physicians and advanced practitioners. SMG operates
approximately 450 practice locations throughout Massachusetts,
Southern New Hampshire, Rhode Island, New Jersey, Pennsylvania,
Ohio, Florida, Utah, Arizona, Texas, Louisiana and Arkansas, and
provides more than 4 million patient encounters per
Responsible for training in CPT assignment for on-boarding
physicians and mid-level providers; Auditing new providers as
described per policy and re-educating as needed. Audit and educate
coding staff as necessary. Reviewing and validating a variety of
charges generated from the providers. Performs in accordance with
the policies and procedures. Follows standards for ethical business
conduct. Conducts self as a positive role model and team member.
Participates in facility committees, meetings, in-services, and
activities as requested.Responsibilities:
--- Collaborate with other departments to resolve billing problems
related to coding, including those stemming from CCI edits and the
outpatient code editor (OCE).
--- Perform coding, documentation, and billing audits in focus
areas as assigned, including summarizing audit findings, and
proposing recommendations. Oversee implementation of audit
recommendations as appropriate.
--- Perform follow-up audits and reviews to monitor and validate
ongoing compliance with applicable rules and guidelines.
--- Maintain excellent intradepartmental communication; maintain
good rapport with Practice Management and other departments and
employees throughout Steward.
--- Educate practices/providers on basic coding, documentation, and
billing issues related to appropriately charging for, and
documenting the services delivered in compliance with applicable
rules and regulations.
--- Educate key stakeholders on significant matters related to
coverage decisions, coding issues, and new or revised
--- Based on experience and industry knowledge, make
recommendations to streamline processes related to accurate and
appropriate revenue capture for services performed, ensuring
compliance with all appropriate regulations and guidelines.
--- Complete required continuous training and education, including
department specific requirements.
--- Maintains certifications and stays current on industry
--- Experience utilizing Microsoft Office required.
--- Experience should include thorough knowledge of health care
operations, physician practice reimbursement including RVUs,
charging practices, governmental coding requirements including
extensive knowledge of CPT / HCPCS / ICD and modifiers, and
healthcare financial systems.
--- Experience in researching, interpreting and applying Medicare,
Medicaid, MASSHEALTH, and other third party payer regulations is
--- Superior analytical skills, excellent writing, organizational
and interpersonal skills.
--- Demonstrated highly developed project management skills, along
with excellent problem solving and analytical skills, and verbal
and written communication skills.Education/Experience/Etc.:
--- Bachelor's degree is strongly preferred.
--- 3+ years of related work experience is preferred.
--- CPC or CCS-P required. Certification of healthcare compliance
(CHC) strongly preferred.
Keywords: Steward Health Care, Salt Lake City , Provider Educator/Auditor, Accounting, Auditing , Salt Lake City, Utah
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