PURPOSE: Provide coding training to providers and ancillary staff on CPT and ICD-10 coding. Act as a resource for expert research on coding issues. This position will have a strong focus on achievement of positive results in assisting providers and ancillary staff to consistently code accurately and appropriately, including providing guidance on workflows and ease and accuracy of documentation, and processing of CCI/system edits efficiently and accurately. Completes all duties while respecting patient confidentiality and promoting the mission and philosophy of the organization supported.
Physician and Staff Support and Education
Organization Support and Education
- Works directly with providers and ancillary staff to provide education on standard coding practices, regularly visiting and spending time at various clinic locations and working alongside providers in order to provide coding and documentation assistance as needed and/or requested.
- Develops and delivers individual and group presentations to assist providers and ancillary staff in gaining a better understanding of documentation and billing guidelines from a clinical perspective.
- Works with providers and related department personnel to evaluate tools utilized to capture the most appropriate documentation and billing for compliance and makes recommendations for modifications or enhancements, as appropriate.
- Establishes and maintains a close working relationship with providers and their staff to work toward a full understanding of documentation and billing guidelines, resulting in accurate representations of services provided.
- Stays abreast of coding methodologies and responds to coding/billing changes or unrealized potential.
- Responds in a timely and accurate manner to all documentation and/or billing compliance questions initiated by providers and ancillary staff.
- Conducts chart reviews on a real-time basis before claims are released by comparing chart notes to billed procedural codes and diagnostic codes. Identifies coding discrepancies and formulates suggestions for improvement. Communicates audit results to providers and ancillary staff and shares improvement ideas.
- Responds in a timely and accurate manner to all documentation and/or billing questions.
OTHER DUTIES AND RESPONSIBILITIES:
- Works in collaboration with staff development on all coding related training to include newcomer’s orientation for providers.
- Assesses effectiveness of training efforts through medical record reviews. Confirms compliance with documentation and billing rules and regulations set forth by the Centers for Medicare and Medicaid Services (CMS), Medicare Carrier and Fiscal Intermediary, state and Board of Medical Examiners regulations and Institutional policies.
- Maintains a thorough understanding of CPT-4, ICD-9-CM, ICD-10-CM and HCPCS coding principles, governmental regulations and third party guidelines regarding documentation and/or billing compliance.
- Provides assistance pertaining to research of technical and professional services and maintains the coding and documentation library by ensuring that all materials are revised and updated with the most current data. This also entails writing/editing documentation, flyers and other educational materials as needed.
- Performs other duties as assigned.
Education: High school diploma or equivalent. Successful completion of medical terminology course required.
Experience: Five (5) or more years of experience with CPT/ICD-9 coding in a multispecialty environment. Previous work experience requiring good communication and use of independent judgment when dealing with coding issues. Experience in adult education a plus.
Knowledge, Skills, Abilities:
Certificate/License: Required to have recognized national coding certification (American Health Information Management Association (AHIMA), Certified Coding Certification (CPC) by the American Academy of Professional Coders (AAPC)). Will be required to maintain a current certification.
- Knowledge of practice management or revenue cycle operations a plus.
- Strong interpersonal communication skills, both verbal and written.
- Skilled in management and leadership techniques.
- Ability to communicate and work effectively with all levels of management, corporate and physician staff..
- Excellent organizational, analytical and problem solving skills with emphasis on thought processing.
- Ability to work independently with limited or little supervision.
- Must be organized and focused with the ability to multi-task.
- Excellent customer service skills.
- Ability to work in a team environment.
- Ability to manage competing priorities.
- Excellent computer and keyboarding skills, including knowledge of EPIC, Excel and other MS Office programs.
Position requires travel to multiple clinic sites throughout the greater Austin area, as well as the need for flexibility to meet with providers at various times throughout the work day.