Director, Provider Coding Educator
Director, Provider Coding Educator
Location: United States - Texas - Fort Worth
Industry: Healthcare / Health Services - Hospital Administration
Job Category: Medical / Health - Administration
This position is responsible for the planning, organization, implementation and maintenance of CCPN providers coding education and training to ensure compliance with established policy/procedure, accuracy, risk management, contractual and regulatory requirements. Serves as the provider coding education liaison to the physician network and other system departments, including Internal Audit and HIMs dept.
Preforms/oversees coding audits: analyzing and evaluating provider documentation and E&M/CPT coding (both medical and surgical; inpatient and outpatient) that meets national standards. Develops and oversees all educational sessions to providers when hired and as needed, monitoring and participating in performance improvement initiatives.
DUTIES AND RESPONSIBILITIES
- Preforms focused audits, reviewing medical record documentation that supports billing, risk management and legal requirements. Works closely with Corporate Compliance Auditors to assist in identifying where there is a need to improve coding compliance and documentation.
- Develops and implements onsite education and training to all CCPN providers to ensure accurate documentation and coding in real time. Serves as a consultant to all providers, helping them to improve documentation and proper coding and ensuring maximizing reimbursement.
- Develops and implement coding education for all new hire providers. Works closely with Corporate Compliance to ensure timely baseline audits and re-audits, providing necessary identified educational sessions.
- Works with the IS department to help accurately develop/enhance the EMR to maximize coding elements within the electronic record. Monitors both documentation and billing templates to ensure quality and compliance.
- Works with the HIMs department to help conduct provider/clinical education sessions to transition to ICD10.
- Performs data analysis, evaluating denial reports of all payers; reporting on physician statistics regarding coding compliance, benchmarking and revenue enhancement opportunities.
- Interacts with external coding resources as necessary, sharing findings and educational opportunities with physicians and leadership.
- Participates in committees, meetings and task forces as pertains to coding, billing and documentation. (Clinical Documentation Program, CDI monthly/quarterly meetings, Medical Record Committee, etc.)
Skills and Certifications [note: bold skills and certification are required]
- RHIA (Registered Health Information Administrator) or RHIT (Registered Health Information Technology)
- CCS (Certified Coding Specialist) or CPC (Certified Professional Coder)
- CDS (Certified Clinical Documentation Specialist)
Security Clearance Required: No
Visa Candidate Considered: No
Full-time Benefits - Full
Relocation Assistance Available - Possible for ideal candidate
Bonus Eligible - Yes
Interview Travel Reimbursed - Yes
- 5+ to 7 years experience
Seniority Level - Director
Management ExperienceRequired - Yes
Minimum Education - Bachelor's Degree
Willingness to Travel - Occasionally
? Technical expertise in coding. Specifically E&M coding for provider services within inpatient and outpatient settings.
? STRONG communication skills. Experience with delivering presentations, conducting one on one education with providers, teaching a coding class, speaking at coding seminars.
? Excellent interpersonal skills. Experience influencing provider behavior. Experience with crucial conversations. Experience discussing coding in layman terms to providers with various learning curves (new grads all the way to seasoned providers)
? Organizational skills. Someone that can demonstrate putting together a presentation, tip sheets or learning curriculum.
? Work experience in provider setting like coding for a private practice group rather than an institution preferred but will consider those with insurance plan or hospital experience too. Work experience as a coder for a consulting firm on coding also a plus! In general we want to find someone who has been motivated by the physician as their client versus an institution?s agenda because we want them to relate to what motivates our providers; understand their workflow and lingo; and appreciate their challenges that impedes appropriate coding in order to influence a change in their behavior.