Day to Day:
• The Physician Coding Education Specialist conducts internal audits and analyzes professional coding to identify inaccuracies and provide support. Their biggest responsibility is provider communication, making sure providers are on the right path, and performing compliance audits as needed. They develop and present educational programs to physicians and staff, ensuring accurate code assignment and compliance with guidelines. Reviewing medical records to ensure accurate code assignment and compliance with governmental and private payer guidelines is also part of the role. They solve complex coding issues, collaborate with the Central Business Office for coding accuracy, and provide statistical reports on efficiency. Maintaining a 90% coding accuracy rate and adhering to ethical standards is crucial.
Must Haves:
• Associate's degree.
• 5+ years of professional based coding experience (multiple specialties is desired: Inpatient, Outpatient, Bedside, Surgical, Office, Teaching & Physician extender provider coding).
• PAST EXPERIENCE AS AN EDUCATOR NOT REQUIRED, they should have extensive auditing experience and the ability to effectively communicate audit findings and provide education.
• Knowledgeable in Microsoft Office.
• Proficient in Excel.
• One of the following certifications: CPC, CCS, CCS-P, CMC, CPMA, CEMA.
• Expertise in coding principles (CPT-4, ICD-10-CM/PCS and HCPCS), regulations, and third-party payer requirements pertaining to billing, coding, and documentation.
• Knowledge of medical terminology.
• EMR system experience.
• 90% on coding skills assessment (thorough knowledge of official coding guidelines as per AMA, AHA, and CMS).
• Strong interpersonal skills: ability to work independently, strong verbal and written communication skills, willing to interact with others, time management.
Plusses:
• Level 1 Trauma Hospital Experience
• EPIC Experience (EMR)
• Experience with a large organization, multi-location, multi-specialty with high volume providers
NOTE, Certifications =
• Certified Professional Coder (CPC) through the American Academy of Professional Coders
• Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA)
• Certified Coding Specialist-Physician (CCS-P) through the American Health Information Management Association (AHIMA)
• Certified Medical Coder (CMC) through Practice Management Institute
• Certified Professional Medical Auditor (CPMA)
• CEMA certification via National Alliance of Medical Auditing Specialists
Compensation:
$27/hr to $37/hr.
Exact compensation may vary based on several factors, including skills, experience, and education.
Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.
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