CarePoint Health-Hoboken University Medical Center

Coordinated Healthcare: That's the Point!
www.CarePoint.org


CarePoint Health has combined the resources of three hospitals— Bayonne Medical Center, Christ Hospital, and Hoboken University Medical Center—and the medical practices of over 300 leading doctors in the Northern New Jersey Area.

We also have insurance and research divisions of our healthcare system. CarePoint Health Plans, headquartered in Jersey City, provides Medicare Advantage programs that serve residents of the Hudson County area, and Care Point Health Research Institute, with locations at each of our three hospitals, has partnered with major pharmaceutical corporations to conduct research to develop treatments for cancer.

General Purpose of Position:

Reviews and interprets patient medical records to ensure correct coding principles, current NCCI rules, NCD and LCD coverage determinations are adhered to.

Duties and Responsibilities:

• Analyzes and interprets medical records in their entirety to ensure accurate, complete and consistent selection of procedures and diagnoses to assure maximum reimbursement of hospital based Provider charges
• Applies and adheres to correct coding principles, current NCCI rules, LCD coverage determinations and current, accepted compliance standards.
• Identifies unbundled procedures according to CPT guidelines and current Medicare CCI rules.
• Corrects coding related denials including medical necessity and modifier usage.
• Reconciles charges daily against census and addresses deficiencies with Providers
• Assist in the education of providers and staff by advocating proper documentation practices to more accurately reflect the acuity, severity, and occurrence of events.
• Serves as an onsite resource for CPT-4 and ICD-9-CM coding and compliance issues.
• Maintain confidentiality in compliance with HIPAA regulations
• Maintain and improve client relations
• Always act in the best interest of the company
• Perform other duties or projects as required or assigned

Educational Requirements:

High school diploma or equivalent, College degree preferred

Current Certified Coding Specialist (CCS); Current Certified Professional Coder (CPC); or Current Certified Coding Specialist-Physician (CPC-P) required

Experience Requirements:

2 + years of current Physician billing experience to include abstracting patient medical records

Knowledge, Skills and Abilities:

• Thorough knowledge of ICD-9-CM, CPT-4, and HCPCS Level II coding
• Understanding of Medical Terminology
• Knowledge of Medicare and other insurance carrier’s coding and compliance guidelines
• Previous experience working with Emergency Department, Radiology and other Hospital based Providers charges
• Ability to work and thrive under pressure while handling multiple priorities and meet deadlines
• Ability to communicate on all levels while fostering positive relationships to further benefit the Company
• A willingness to assist with a variety of company projects as needed

We are an Equal Opportunity Employer and a member of the Employer Partnership of the Armed Forces.