Under general supervision of Regional Coding Educator, the Coding Educator will assist with development and execution of coding education programs for his/her individual market to ensure coding compliance throughout the local market.
Serve as ICD-10 Subject Matter Expert (SME) providing on-going ICD-10 training in his/her individual market (other markets as needed) and be available to answer questions and provide guidance for physicians, providers and staff;
Assist Regional Coding Educator develop and conduct classroom, webex and/or on-the-job training for new and existing coders and providers with basic, specialty specific and HCC risk adjusted educational offerings for his/her individual market;
Assist Regional Coding Educator administer knowledge checks to ensure market coding staff are appropriately trained and have coding skill sets necessary to be successful within TPR and to be compliant with applicable compliance regulations;
Collaborate with Coding Manager, if applicable, to run quarterly E&M code utilization reports to monitor provider coding patterns and conduct spot checks of documentation for providers whose E&M patterns deviate from the norm;
Assist Market , Regional or National Coding Operations Manager to perform annual provider E&M documentation reviews of 5 encounters for all providers in the markets to ensure accurate selection of evaluation and management and procedure codes to be in compliance with Medicare, Medicaid and other payer requirements, as needed;
Develop provider education, as needed, based upon these reviews;
Assist in monitoring .edu and E&M University course completion, as needed;
Assist with individual market pre-bill clearance reviews, as needed;
Assist Regional Coding Educator to develop market specific coding education for providers and coders resulting from results of pre-bill clearance reviews;
Assist individual market coding staff with day-to-day coding duties, as needed, including but not limited reviewing provider documentation to ensure assignment and sequencing of procedural and diagnostic coding to ensure accurate and timely submission of claims;
Assist market coding staff with coding tasks, as needed, to ensure timely processing of payer denials and adherence to RCM KPI metrics;
Ensure compliance with Federal and State regulations; and
Participate and complete special projects and other duties as assigned
Expert working knowledge of CPT-4, ICD9, ICD-10-CM and HCPCS codes;
Strong understanding of coding and documentation issues facing the healthcare industry;
Knowledge of and ability to apply billing compliance program rules, regulations, policies and procedures;
Ability to communicate coding concepts to medical staff and management;
Obtain necessary CEUï¿½s to maintain coding credentials and stay abreast of coding changes within the industry;
Good computer skills using a medical management system as well as proficiency with Microsoft applications;
Adhere to the ï¿½Coders Code of Conductï¿½ ;
Maintain a strong work ethic and a high level of professionalism; and
Ability to work independently.
ï¿½Must have a high school diploma or equivalent. Associateï¿½s degree in related field preferred
ï¿½Completion of college level courses in medical terminology, anatomy and physiology, disease processes and pharmacology highly desirable.
ï¿½Must be certified through the American Academy of Professional Coders (AAPC) as a Certified Professional Coder (CPC), Preferred
ï¿½Must be certified through the American Health Information Management Association (AHIMA) as a Certified Coding Specialist Physician Based (CCS-P)
ï¿½5+ years of coding experience
Job: Medical Coding
Primary Location: Worcester, Massachusetts
Facility: Staff St Vincent Phy Svs
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 1905038616
About Staff St Vincent Phy Svs
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.