Coding Quality and Educational Coordinator

Job Description

Job Description

Description:

GENERAL SUMMARY

The Coding Quality and Educational Coordinator role is a cornerstone of modern healthcare operations,

operating at the critical intersection of clinical documentation, precise coding, regulatory adherence, and

financial integrity. This position is a strategic asset that proactively safeguards an organization's revenue

streams, significantly mitigates compliance risks, and consistently elevates the overall quality of medical coding

practices. Through auditing, comprehensive educational initiatives, and continuous monitoring of evolving

healthcare regulations the coordinator ensures that patient care is accurately translated into standardized codes.

ESSENTIAL JOB FUNCTION/COMPETENCIES

The responsibilities and duties described in this job description are intended to provide a general overview of the position. Duties may vary depending on the specific needs of the affiliate or location you are working at and/or state requirements. Responsibilities include but are not limited to:

• Rule writing within Aptarro RCX rules based on NCD's, LCD's, Carrier Policies and CCI edits to ensure medically necessary ICD 10 codes and appropriate modifiers are appended prior to submission.
• Education and Training Initiatives delivers a comprehensive coding education and training programs.
• Educational mandate involves instructing healthcare providers on proper documentation practices.
• The coordinator also provides essential guidance, mentorship, and support on complex coding related questions.
• The coordinator monitors training effectiveness through assessments and feedback mechanisms, driving continuous improvement among auditors, coders and providers.
• The educational role is uniquely positioned to bridge the divide between clinical practice and coding requirements, thereby achieving significant upstream impact.
• The coordinator provides consistent emphasis on educating physician and APP's and providing feedback to physicians and support staff, highlights a critical, often underestimated, function.
• Accurate coding fundamentally relies on complete and precise medical records documentation best practices, the coordinator directly influences the quality of data at its source.
• Stays accountable to quality and productivity standards, and monitor compliance with policies and procedures.
• Identifies process opportunity trends and recommend ways to improve efficiencies.
• Responsible for maintaining current knowledge of coding guidelines and relevant state and federal regulations.
• Ensures adherence to third party and governmental regulations relating to coding, documentation, compliance, and reimbursement.
• Participates in special projects, personal development training, and cross training as instructed.
• Works in conjunction with peers and functional areas of the Coding and Revenue Integrity department for the betterment of completing tasks and the company overall.
• Coordinates training sessions for all new hires to the RCM Charge Capture team.
• Coordinates continuing training sessions for all Charge Capture team members.
• Performs other position related duties as assigned.
• Employees shall adhere to high standards of ethical conduct and will comply with and assist in complying with all applicable laws and regulations. This will include and not be limited to following the Solaris Health Code of Conduct and all Solaris Health and Affiliated Practice policies and procedures; maintaining the confidentiality of patients' protected health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA); immediately reporting any suspected concerns and/or violations to a supervisor and/or the Compliance Department; and the timely completion the Annual Compliance Training.

CERTIFICATIONS, LICENSURES OR REGISTRY REQUIREMENTS

• CPC, CCS-P, CMRS or AAPC required.

KNOWLEDGE | SKILLS | ABILITIES

• Demonstrates understanding of business and how actions contribute to company performance.
• Demonstrates excellent customer service skills.
• Knowledge of medical terminology, Current Procedural Terminology (CPT), International Classification of Disease (ICD) coding, and the entire revenue cycle process.
• Knowledge of EHR (Electronic Health Record) software systems and Microsoft Office products.
• Professional verbal and written communication skills.
• Ability to develop reports and create presentations.
• Ability to work collaboratively across disciplines and business lines.
• Must be comfortable working with team members.
• Ability to handle multiple tasks with excellent problem-solving skills.
• Strong analytical skills with ability to make conclusions and recommendations.
• Well organized with the ability to maintain accuracy and confidentiality. ?
• Self-driven and motivated to maintain productivity and efficiency levels.
• Excellent verbal and written communication skills.
• Skill in using computer programs and applications including Microsoft Office.
• Complies with HIPAA regulations for patient confidentiality.
• Complies with all health and safety policies of the organization.

EDUCATION REQUIREMENTS

• High School Diploma or equivalent required.

EXPERIENCE REQUIREMENTS

• At least 3 years’ experience to successfully perform this job.
• Entry level Medical Billing and Coding Terminology preferred.
• Experience in Urology or physician practice environment preferred.

REQUIRED TRAVEL

• N/A

PHYSICAL DEMANDS

Carrying Weight Frequency

1-25 lbs. Frequent from 34% to 66%

26-50 lbs. Occasionally from 2% to 33%

Pushing/Pulling Frequency

1-25 lbs. Seldom, up to 2%

100 + lbs. Seldom, up to 2%

Lifting - Height, Weight Frequency

Floor to Chest, 1 -25 lbs. Occasional: from 2% to 33%

Floor to Chest, 26-50 lbs. Seldom: up to 2%

Floor to Waist, 1-25 lbs. Occasional: from 2% to 33%

Floor to Waist, 26-50 lbs. Seldom: up to 2%