Coding Quality Educator

The Coding Quality Educator plays a key role in supporting the Enterprise Professional Coding team by strengthening the connection between clinical documentation and compliant coding practices. This position serves as a strategic partner to providers and coders, offering education on documentation improvement, regulatory guidelines, and coding accuracy to ensure appropriate reimbursement and revenue integrity.

The educator conducts coding and documentation reviews, identifies trends, and provides targeted training for coders, physicians, residents, and allied health professionals. This role requires deep expertise in ICD-10-CM, CPT, HCPCS, and CMS guidelines, along with strong analytical, communication, and instructional skills.

The ideal candidate will bring hands-on auditing and coding experience, proven effectiveness in adult education, and the ability to collaborate with clinical and administrative leaders to enhance documentation quality, compliance, and overall coding performance across the organization.

Collaboration and Support

• Act as a liaison between coding teams, healthcare providers,and other stakeholders to resolve coding and documentation issues.
• Review and respond to inquiries from coders and providersregardingcomplex coding issues and documentation concerns.
• Establish collaborative relationships with physician leaders, clinicalprovidersand administrative leadership in the support of coding and documentation adequacy.
• Review and interpret the FederalRegister,CPT,AMA, WHO,CMS,and other payer guidelines, along with relevant publications, to stay updated on coding changesimpactingUVAHealth System.
• Collaborate with the team to compile coding and documentation updates and tips into a monthly Newsletter.
• Participate in special projects and perform other duties as assigned.

Coding Review:

• Conductcomprehensivereviews of coded claims and medical recordsforprofessional servicesto ensure compliance with ICD-10CM, CPT, HCPCS,and documentationstandardsusingMDAudit
• Perform quality reviews onexternal(3rdparty)vendors and team membersto ensureaccountability anduphold thedepartmentshigh standards
• Track andreportcoding errors and trends,providingrecommendations for process or documentation improvements.

Education and Training

• Developscomprehensivetraining materials and delivers professional presentations to educate and engage providers, allied health professionals, residents, and coding staff, ensuringadherence tofederal,stateand regulatory compliance standards.
• Utilizes various training formats,includingclassroomsessions, one-on-one provideron-site or web-based education,andprovidershadowing whenappropriate.
• Presents findings from internal and external(3rdparty)audits to clinical departments andproviders, ensuringaccuratedocumentation practices that align with FederalRegister, AMA,WHO,and CMS guidelines.

The Ideal Candidate Will Have:

• Provenexperience in adult education and training
• Comprehensiveknowledge of ICD-10-CM, HCPCS, NCCI,and CMS coding guidelines
• Familiarity withEpic or similar electronic medical record systems
• Experience withMD Audit
• ProficiencyinMicrosoftOffice Suite (Work, Excel, PowerPoint)
• Knowledge ofSmartsheet's
• Experience with Evaluation and ManagementCoding/Auditing

Preferred Skills:

• Effective interpersonal communication skills
• Stronganalytical and researchabilities
• Ability tomaintaingood working relationships and rapport with project stakeholders
• Capability toimprove team performance by mentoring, training,and motivation.
• Excellentanalytical and problem-solvingskills
• Ability to interpret CMS regulations and guidance

Core Competencies

• Education & Training Excellence:Expertisein developing and delivering high-quality educational programs and training sessions.
• Quality Assurance & Attention to Detail:Strong focus onmaintaininghigh standardsand meticulous attention to detail in all tasks.
• Strategic Planning & Implementation:Proven ability to create and executeastrategic plan effectively
• Regulatory Compliance Knowledge:In-depth understanding of regulatory requirements and compliance standards.
• Communication & Interpersonal Skills:Exceptional ability to communicate clearly and build strong interpersonal relationships.
• Project Management:Skilled in managing projects frominceptionto completion, ensuringtimelydelivery and adherence toobjectives.
• Change Management:Proficient in guiding and managing organizational change processes.
• Customer Service Focus:Dedicated to providing excellent customer service and ensuring provider satisfaction
• Technical Expertise:Advanced technical skills and knowledge in relevant areas.

MINIMUM REQUIREMENTS

Education: Bachelor's Degree required or relevant experience may be considered in lieu of Bachelor's degree.

Experience: 5 years relevant experience required. 5 years of coding experience in a tertiary setting preferred.

Licensure: Coding certification through the AHIMA or AAPC as a RHIA, RHIT, CCS, CCS-P, CPC, CCA, and CPC, preferred.

PHYSICAL DEMANDS

This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally require traveling some distance to attend meetings, and programs. The starting base rate for this role is $68,620.00 annually. Individual compensation will be determined by the selected candidate's qualifications, previous work experience, and/or education.

Benefits

• Comprehensive Benefits Package: Medical, Dental, and Vision Insurance

• Paid Time Off, Long-term and Short-term Disability, Retirement Savings

• Health Saving Plans, and Flexible Spending Accounts

• Certification and education support

• Generous Paid Time Off

UVA Health is a world-class Magnet Recognized academic medical center and health system with a level 1 trauma center. 2023-2024 U.S. News & World Report "Best Hospitals" guide rates UVA Health University Medical Center as "High Performing" in 5 adult specialties and 14 conditions/procedures. We are one of 70 National Cancer Institute designated cancer centers. UVA Health Children's is named by 2023-2024 U.S. News & World Report as the best children's hospital in Virginia with 9 specialties ranked among the best in the nation. Our footprint also encompasses 3 community hospitals and an integrated network of primary and specialty care clinics throughout Charlottesville, Culpeper, Northern Virginia, and beyond.

The University of Virginia is an equal opportunity employer. All interested persons are encouraged to apply, including veterans and individuals with disabilities. Learn more about UVA's commitment to non-discrimination and equal opportunity employment .