Purpose: To conduct quality assurance reviews of physician coding and documentation and to provide education to physician regarding the results of such reviews.

Duties and Responsibilities:

• Conduct reviews of patient charts for designated group faculty to determine accurate CPT, HCPCS procedure and professional supply codes and ICD-10-CM diagnosis codes used for billing services provided by physicians and licensed non-physician providers.
• Providing individual educational sessions with physicians to 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.
• 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 to new physicians.
• Conduct research on various compliance and documentation issues.
• Respond to and track third party inquiries regarding level of service coding by the physicians.
• Distribute the OSUP Compliance Program to all persons and entities identified as involved in documenting, coding and billing for services within the designated group.
• Review explanations of benefits (EOB’s) from payers, evaluating denied claims and filing appeals for denied claims.
• Serve as a liaison between coding and billing personnel and physicians.
• Preparing weekly reports of audit and education activities.
• Develop tools for physician use to aid with documentation and billing, as requested.
• Participate on committees or workgroups as needed.
• Complete other compliance related projects as assigned.

• 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.

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