Full Job Description
The Coding Quality and Education Advisor oversees the medical coding department, ensuring accurate and compliant coding practices that optimize revenue cycle performance.
Essential Duties:
Coding Operations
• Ensure coding compliance with CMS, AMA, AHA, and payer-specific guidelines.
• Oversee the coding of diagnoses, procedures, and services using ICD-10-CM, CPT, and HCPCS codes.
• Review coding audits and implement corrective actions when necessary.
• Review Medical Records for inconsistent coding practices and offer remediation solutions.
Workflow & Process Improvement
• Analyze and streamline coding workflows for efficiency and accuracy.
• Utilize data analytics and reporting to identify trends, discrepancies, or training needs.
• Participate in company-wide initiatives related to clinical documentation improvement.
Collaboration
• Liaise with physicians, clinical staff, billing, and revenue cycle teams to clarify documentation and resolve coding-related issues.
• Support accurate clinical documentation improvement (CDI) efforts.
• Perform ongoing outreach/education for new and existing clinicians for Emergency Medicine and/or Hospital Medicine documentation requirements using a variety of formats.
• Advise and educate internal operations teams on documentation coding by participating in Monthly Facility/Team Meeting group sessions.
• Participate in provider Electronic Medical Record (EMR) training and provide feedback/clarification on documentation and coding workflow concepts.
Skills, Knowledge, Abilities:
• Strong organizational skills with the ability to multi-task in a fast-paced environment.
• Ability to adapt, modify and prioritize while adhering to strict deadlines and a willingness to shift priorities to meet the needs of the organization.
• Knowledge and understanding of medical coding and billing systems and regulatory requirements. Knowledge of legal, regulatory and policy compliance issues related to medical coding and billing procedures and documentation.
• Excellent communication and interpersonal skills and demonstrated ability to interact with a variety of team members.
• Self-motivated with the ability to identify opportunities for improvement and demonstrate the initiative to resolve issues in support of improvement efforts.
• Strong analytical skills and the ability to work independently to analyze and solve problems.
• Adept at learning proprietary software applications.
• Collaborate with professionals internal and external to the company and across geographic locations.
• Exhibit growth mindset and team-orientated behaviors.
• Navigate competing priorities and effectively work in a fast-paced environment.
Requirements
Education:
• Preferred: RHIA, CDI, CPC, CCS, CCS-P
• Bachelor's degree or equivalent is required
Experience:
• 3-5 years' experience in Hospital or Physician practice environment desired.
• Experience with Evaluation & Management coding; hospital medicine background preferred.
• EHR/EMR (Electronic Health Record/Electronic Medical Record) experience required.
• Chart Auditing/Optimization experience is a must