Outpatient Coding Educator

Summary:

Provides physician medical practice coding billing and documentation auditing for professional coding at Nuvance Health. Conducts routine quality assurance (QA) audits on Professional Coding team and compiles reports on their accuracy for leadership. Makes recommendations based on audit findings for educational programs for both coding personnel and clinical staff. Develops and delivers education to physicians and professional fee coders. Requires advanced expertise in medical terminology anatomy physiology documentation coding guidelines state and federal regulations.

Responsibilities:

high volume internal audits of physician practice medical records for documentation and coding accuracy.

and delivers education sessions for Nuvance coders and medical practice clinical personnel based on the audit findings and as needed or requested to reinforce proper documentation and coding consistent with Nuvance Health policies State and Federal regulatory and guidelines and maintaining compliance while optimizing revenue opportunities

3. Attends practice and service line meetings as needed or requested to deliver education and stay current with information that may affect professional coding and clinical personnel

QA activities for professional fee coders and medical practice clinical personnel.

closely with the Compliance department on audits reporting complaint coding issues etc

CMS and NGS Medicare regulations guidelines bulletins and other publications for impact to professional services. Monitor listservs such as CMS Medicare NGS AAPC etc. and third-party payers for coding and billing guidelines and regulations professional peer organizations practices/policies/guidelines to help keep Nuvance physician practices current with coding and regulatory requirements and accepted compliance practices. Stay current with OIG Work Plan.

with professional fee coding team to identify errors patterns trends and variations in coding or documentation. Provides recommendations to Manager or Director to improve coding and documentation practices.

required educational sessions (webinars conferences etc.) to maintain and enhance coding certification(s)

and Model Nuvance Health Values

regular reliable and predictable attendance.

other duties as required.

Education Skills Experience:

• 5 Years demonstrated coding experience in appropriate application of coding and documentation guidelines
• Specialized training in medical terminology ICD-10-CM/CPT and E&M coding.
• Prior experience auditing in E&M Leveling facility and professional
• Prior teaching/instructing experience in a healthcare setting
• Certification from the American Academy of Professional Coders (AAPC) of the American Health Information Management Association (AHIMA) - CPC or CCS-P required
• Certified Professional Medical Auditor (CPMA) or Certified Documentation Expert Outpatient (CDEO) required

Other Information:

• 5 Years demonstrated coding experience in appropriate application of coding and documentation guidelines
• Specialized training in medical terminology ICD-10-CM/CPT and E&M coding.
• Prior experience auditing in E&M Leveling facility and professional
• Prior teaching/instructing experience in a healthcare setting
• Certification from the American Academy of Professional Coders (AAPC) of the American Health Information Management Association (AHIMA) - CPC or CCS-P required
• Certified Professional Medical Auditor (CPMA) or Certified Documentation Expert Outpatient (CDEO) required

Working Conditions:

Manual: Little or no manual skills/motor coord & finger dexterity

Occupational: Little or no potential for occupational risk

Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Physical Environment: Generally pleasant working conditions

Company: Nuvance Health

Org Unit: 2069

Department: CODERS - PROFESSIONAL & FACILITY CHARGING and CODING

Exempt: No

Salary Range: $29.65 - $55.55 Hourly