Educate and support physicians and PB coders in accurate, complete, and compliant clinical documentation and coding practices by interpreting patient medical records, providing targeted feedback, and promoting adherence to regulatory guidelines to support appropriate reimbursement.
Responsibilities include:
- Serve as the primary point of contact and resource for physicians and APPs regarding clinical documentation and medical coding for patient care services.
- Develop tools to help providers improve documentation efficiency, effectiveness, and coding accuracy.
- Identify documentation trends and share findings with the Physician Champion to support clinician education.
- Provide group and one-on-one education for faculty, APPs, and house officers as needed.
- Prepare case- and specialty-specific documentation examples and PowerPoint presentations for department meetings.
- Orient new physicians to the coding department's role in the revenue cycle and prepare training materials for coding-related physician education.
- Maintain a consistent coding operations orientation program and report coder progress to Coding Leadership throughout orientation and training.
- Perform chart reviews and provide feedback to individual providers and coders.
- Conduct, track, and communicate provider chart reviews.
- Prepare coder/provider review results for leadership reporting.
- Develop educational materials based on audit results and review them with coding staff, providers, and other stakeholders.
- Assist coding leadership with training and development to improve team performance.
- Assist the Coding Supervisor with reviewing and responding to external coding audits.
- Serve as a subject matter expert on official coding guidelines.
- Monitor changes to coding methodologies, official coding guidelines, regulatory standards, and reimbursement schemes.
- Maintain current knowledge of CPT, HCPCS, and ICD-10-CM coding.
- Stay current on billing and coding rules and regulations affecting government and non-government payers and disseminate updates as needed.
- Review and research coding and billing issues, including rejection reports and claim denials.
- Analyze the impact of coding and clinical documentation on reimbursement and identify trends and improvement opportunities.
- Adhere to compliance regulations, the Christ Hospital Code of Conduct, core values, and AAPC/AHIMA codes of ethics.
Requirements & Qualifications
Education and experience:
- Associate degree in HIM with RHIT, or CCS-P, or CPC required.
- 5 years of related experience in multiple specialties required.
- Skills assessment required to determine coding competency.
Knowledge and skills:
- Working knowledge of Medicare regulations on charging and billing practices, including UB92 and 1500/HCFA.
- Knowledge of CPT and HCPCS coding.
- Ability to read and analyze itemized billing statements, medical records, and lab reports.
- Strong knowledge of ICD-10 and CPT coding guidelines, medical terminology, anatomy, and physiology.
- Ability to accurately code diagnosis, diagnostic, and surgical procedures in multiple specialties with in-depth knowledge of Evaluation and Management (E/M) coding.
- Strong understanding of legal, regulatory, and policy compliance issues related to medical coding and documentation.
- Effective verbal and written communication skills, including communication with physicians and groups.
- Research skills, including use of automated analysis tools and online research tools to resolve complex coding and healthcare issues.
- Ability to work effectively in a team environment and present audit findings, risk areas, and compliance issues.
- Strong confidentiality practices and protection of sensitive data.
- Strong Microsoft Excel skills, including data management and data interpretation.
- Ability to learn and work with Charge Capture software.
Location
Cincinnati, Ohio, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
3 months ago