Physician Coding Ed Specialist- Alabama

Physician Coding Education Specialist

This opportunity is a hybrid role requiring occasional on-site presence and residency in the Birmingham, AL area. Location: Hybrid, Remote 90% & On-site 10% Status: Full Time (exempt) Days: Monday through Friday Shift: Day (flextime plan with the possibility of occasional early morning/evening hours)

Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. "Orlando Health Is Your Best Place to Work" is not just something we say, it's our promise to you.

Performs, develops, and implements coding related efficiency processes to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Education Specialist is responsible for analyzing physician coding trends and providing educations that will contribute to effective productivities.

Responsibilities Essential Functions:

• Responsible for internal auditing and analyzing professional coding for all service lines.
• Review medical records to ensure accuracy of code assignment.
• Guide and educate coding team members by addressing errors, performance issues, and trends identified through reporting.
• Takes an active role in developing and presenting educational programs to physicians, physician extenders, and physician offices.
• Effectively communicates best practice physician coding related feedback with physicians, non-physician providers, physician office staff, administration, practice managers, and team members of the Physician and Professional Services Central Business Office.
• Collaborates with Physician and Professional Services Central Business Office to ensure appropriate and complete follow up of patient accounts to ensure coding accuracy for payor guideline reimbursement.
• Addresses all Orlando Health departments professionally and positively, in all settings, by always maintaining a high level of professional demeanor and dress.
• Provides statistical reports to deliver accurate documentation of ongoing internal coding efficiency process.
• Conducts focused physician reviews as needed and provides data to manager.
• Maintains 90% physician coding accuracy rate.
• Attends payor, departmental and interdepartmental meetings as required.
• Prepares/distributes information summarizing opportunities with physician coding monthly.
• Researches, identifies, develops, and assists in implementation of a plan of action to resolve coding disputes with payors.
• Utilizes resource material available in department, CMS, AMA, and AHCA and federal registry to support coding practices.
• Perform physician queries for coding and documentation clarification during concurrent chart review process.
• Serves as a preceptor to new coders.
• Takes an active role in developing and presenting educational programs to Physician & Professional Services team, physicians, physician extenders, physician offices, and all members of the coding team and manager.
• Maintains patient and coder confidentiality results.
• Proficiency in coding including ICD-10, CPT, E/M, modifiers while maintaining a 90% accuracy.
• Adhere to Standards of Ethical Coding, all applicable regulations and guidelines, and all client specific policies.
• Other duties as assigned based on company needs and projects.
• Ongoing Coding Education and training activities
• Responsible for the development and training of staff within the scope of his/her responsibilities as it relates to Coding Department structure

Other Related Functions:

• Attends payor, departmental and interdepartmental meetings as required.
• Other duties as assigned based on organization needs and projects.
• Works in collaboration for testing, training, and mentoring incoming coders according to the coding guidelines and individual skills for the Division for which the coder will be assigned.
• Conducts focused physician reviews as needed and provides data to manager.

Qualifications Skills Knowledge:

• Excellent knowledge of CPT-4, ICD-10-CM/PCS and HCPCS coding principles, governmental regulations, protocols, and third party payer requirements pertaining to billing, coding and documentation
• Knowledge of medical terminology
• Experience working with Electronic Medical Records
• Ability to work independently
• Strong interpersonal and presentation skills paired with advanced written and verbal communication skills
• Strong analytical and writing skills required for proposal and report development

Education/Training:

• Associate degree required.
• Five (5) years of directly related work experience may substitute for the associate degree.
• Possesses exceptional knowledge in Microsoft Office Word, Outlook, and PowerPoint as well as moderate to expert experience with Microsoft Excel.
• Thorough knowledge of official coding guidelines as per AMA, AHA, and CMS as evidenced by results of coding skills test of 90% or better.

Licensure/Certification:

• Must maintain one (1) of the following national 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

Experience:

• 5-6 years of professional based coding experience is required.
• Professional based coding experience must include Office, Inpatient, Bedside Procedures, Surgical Coding, Teaching & Physician extender provider coding, multiple specialties is desired.
• Level one (1) Trauma hospital experience is preferred.
• Experience with a large organization, multi-location, multi-specialty with high volume providers is preferred.