The Coding Educator reports to the Coding Manager. S/he provides specific education to providers and all support staff through a variety of mediums including direct interactive learning sessions individually or in group settings, written guides and protocols, audits etc. S/he will have responsibility for building relationships with the clinical and clerical teams to ensure open communication for questions concerning the Coding & Auditing programs and their components. S/he will facilitate & provide detailed analysis, reporting, training, education and support to Providers and staff to promote accurate clinical documentation to support the services billed. S/he provides support to the Coding Manager, Coding and Billing teams as well as other departments as needed. Additional duties as assigned.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
- Ensure compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for CMS Guidelines.
- Develops a curriculum, handbook and resource material.
- Coordinates and facilitates current coding and billing education and training using a wide variety of methods and media to deliver content, including printed materials and technical reports, power point presentations, teleconference and videoconference platforms.
- Coordinates with Millennium University on the above as needed.
- Coordinates with the Compliance Officer as needed.
- Performs research for coding related issues that arise.
- Deliver content professionally and customize to specific audiences.
- Demonstrate technical knowledge through the use of industry-based applications.
- Coordinate with the Coding Manager and Coders to develop follow-up content with providers on opportunities identified in their reviews.
- Perform random chart audits, special projects and internal coder assessments as needed.
- Collaborate with other departments to enhance the total provider experience.
- Provides clear, concise and professional communication to varying audiences depending on the project and its goals.
- Provide continual coding and payer updates.
- Maintains knowledge of Medical Terminology, Anatomy and Physiology, ICD9-10, CPT, Coding guidelines and methodologies, DRG, APC, NCCI, LCD, NCD. and coding of diagnoses and procedures.
- Perform analysis of benchmarking profiles for coding accuracy and revenue accuracy.
- Demonstrates excellent time management, attends and participates in required meetings which may require travel and deadlines including hours outside of standard business hours and/or above a 40-hour week.
- Maintains all required CME and Certifications.
- Supports all Millennium teams in a positive manner with emphasis on providing excellent service to all patients, providers, internal and external customers.
- Abides by company Standards of Behaviors.
This job has no supervisory responsibilities.
To perform the job successfully, an individual should demonstrate the following competencies:
Adaptability Maintaining effectiveness in varying environments and with different tasks, responsibilities, and people.
Analysis/Problem Assessment Securing relevant information and identifying key issues and relationships from a base of information; relating and comparing data from different sources; identifying cause-effect relationships.
Communication - Expressing ideas effectively in individual and group situations (including nonverbal communication); adjusting language or terminology to the characteristics and needs of the audience. Good listening skills.
Compassion - The responsibility to put a patient's or person's interests first, including the duty not to harm, deliver proper care, and maintain confidentiality.
Compliance - Employee has satisfactory completed employers required compliance training.
Employee is able to demonstrate an understanding of employers Code of Conduct.
Dependability - Meets commitments, deliverables, deadlines, work independently, accepts accountability, handles change, sets personal standards, stays focused under pressure, and meets attendance/punctuality requirements.
Follow-up - Establishing procedures to monitor the results of delegations, assignments, or projects; taking into consideration the skills, knowledge, and experience of the assigned individual and characteristics of the assignment or project.
Initiative - Making active attempts to influence events to achieve goals; self-starting rather than accepting passively; taking action to achieve goals beyond what is required; being proactive. Practices self-development.
Integrity - Maintaining and promoting social, ethical, and organizational norms is conducting internal and external business activities.
Judgement/ Problem Solving - Recognizes problems and responds, systematically gathers information, sorts through complex issues, seeks input from others, addresses root cause of issues, makes timely decisions, can make difficult decisions, uses consensus when possible, and communicates decisions to others.
Patient Service Orientation - Proactively developing patient/customer relations by making efforts to listen and understand the customer and their needs (both internal and external); anticipating and providing solutions to customer needs; giving high priority to patient/customer satisfaction. Ensures appropriate follow up and is their advocate in determining solutions. The employee uses a variety of communication techniques to effectively express thoughts and ideas and to understand or influence.
Practical Learning - Assimilating and applying, in a timely manner, new job-related information that may vary in complexity.
Quality Orientation/ Attention to detail - Is attentive to detail and accuracy, is committed to excellence, looks for improvements continuously, monitors quality levels, finds root cause of quality problems, owns/acts on quality problems.
Results Driven& Execution - Accountable for meeting or exceeding individual and/or department goals and objectives. Committed to producing results that will achieve company objectives. Sets priorities and organizes time to meet or exceed goals, follows up, and takes personal responsibility for results whether they are positive or negative. Team work/ Collaboration - Working effectively with team/work group or those outside formal line of authority (e.g., peers, senior managers) to accomplish organizational goals; taking actions that respect the needs and contributions of others; contributing to and accepting the consensus; subordinating own objectives to the objectives of the organization or team. Listens to others and values opinions.
Technological /Professional knowledge - Having achieved a satisfactory level of technical and professional skills/knowledge in job-related areas; keeping abreast of current developments and trends in area of expertise.
Work Standards - Setting high goals or standards of performance for self, direct reports, others, and the organization; being dissatisfied with average performance; self-imposing standards of excellence rather than having standards imposed by others.
- Minimum of 5 years of recent physician experience coding, including but not limited to Evaluation & Management, Diagnoses and Procedures in a multi-specialty setting.
- Minimum of 3 years of experience in coding compliance audit work required.
- CPMA, CCS, CPC and/or CCP certification required.
- Member in good standing with AAPC.
- Must have knowledge of Medical Terminology, Anatomy and Physiology, ICD9/10, CPT, Coding guidelines and methodologies, DRG, APC, NCCI, LCD, NCD.
- Computer skills required. Experience with Electronic Record Systems required.
- Must possess excellent communication and interpersonal skills. Must be able to work in a virtual setting under minimal supervision.
- Must have the ability to maintain composure and professionalism in difficult situations.
- Must have excellent phone etiquette and the ability to provide education through a variety of mediums
Education and/or Experience
Associate's degree or equivalent from two-year college or technical school; or equivalent combination of education and experience.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
Ability to apply basic math, as necessary.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
To perform this job successfully, an individual should have proficient knowledge of Microsoft Excel Spreadsheet software; Microsoft Word Processing software, PowerPoint, Outlook and ADP Payroll systems. Knowledge of Computers, Fax, Portals, Uploading, Downloading, Athena or other Electronic Medical Record System.
Certificates, Licenses, Registrations
Must hold active CPMA, CCS, CPC and/or CCP certifications. Must be in good standing with the AAPC. Must complete all required CME to maintain Certifications.
Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms; climb or balance and talk or hear. The employee is frequently required to stand and walk. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate depending on business activity of the office.0