Investigate, respond to and communicate information regarding Departmental coding, documentation, compliance and reimbursement questions. Compile and analyze data, assist in identifying appropriate codes for services and support, provide analysis for and advise management regarding revenue and reimbursement issues. Work with the finance department to perform research and provide recommendations on fees and the use of procedure codes in a timely manner. Analyze coding issues/questions from both a compliance and reimbursement perspective. Provide compliance/documentation education to providers and staff as requested. Provide accurate and up-to-date information on regulatory and reimbursement requirements. Provide coding expertise for all compliance and reimbursement issues. Perform chart reviews for services billed. Consult with provider for clarification of clinical data when ambiguous information is encountered. Participate in the rejections and claims review process to ensure both compliance and maximization of appropriate department reimbursement. Participate as an active member of both Departmental Quality Assurance and Compliance initiatives for the department. Contribute to Quality Improvement initiatives and performance measurement system. Coordinate with other agencies and institutions, particularly in the development and process of special projects. Perform community engagement as needed on behalf of the agency. Provide direct services if needed in program areas. Represent the agency on occasions at local or state meetings or events. Keep Director informed appropriately, regarding unusual or significant matters.
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