Coding Educator-Auditor

This is a hybrid position that will work from home and within the clinics providing training to providers.
JOB SUMMARY
/
PURPOSE P
rovides formal and informal coding and regulatory education/training to Providers and Professional Coders. The education will include coding and documentation requirements as directed by Federal and State requirements as well as the
AMA
. Serves as a liaison between providers and coders. Responsible for reviewing (auditing) professional charges, medical records, and claims to ensure accuracy and compliance with the
CMS
guidelines as well as
CPT
,
HCPCS
,
ICD
-10 coding guidelines. Identifies errors, inconsistencies, and areas for improvement in coding and documentation with current guidelines and regulations. Compiles and presents reports of audit results, highlighting areas for improvement, educating, and reauditing. Answers coding questions for clinic managers, providers, and other staff.
DEPARTMENT DESCRIPTION T
he Regional Business Office Physician Coding Team is responsible for the accurate and timely coding of the Samaritan Health Services clinic providers according to all applicable guidelines with applicable federal/state rules and regulations.
EXPERIENCE
/
EDUCATION
/
QUALIFICATIONS H
igh school diploma or equivalent required. Two (2) certifications (
CPC
,
CRC R
isk adjuster,
CPMA
,
CPCO
compliance officer, or
RHIT
) required upon hire. Three (3) years experience in
CPT EM
leveling,
ICD
-10 diagnosis coding,
HCC
diagnosis coding, medical claims auditing, and provider education required. Experience with data analysis and report preparation required.
KNOWLEDGE
/
SKILLS
/
ABILITIES S
trong knowledge of healthcare regulations and standards, including Medicare and Medicaid. Knowledge of coding and billing practices in healthcare. Strong problem-solving and critical thinking skills. Excellent attention to detail and ability to identify errors and discrepancies. Excellent verbal and written communication skills. Ability to work independently and as part of a team. Ability to work well under pressure and meet tight deadlines. Proficiency in Microsoft Office and other relevant software applications.
PHYSICAL DEMANDS R
arely (1 - 10% of the time) Occasionally (11 - 33% of the time) Frequently (34 - 66% of the time) Continually (67 – 100% of the time)
CLIMB
-
STAIRS LIFT
(Floor to Waist: 0"-36") 0 - 20 Lbs
LIFT
(Knee to chest: 24"-54") 0 - 20 Lbs
LIFT
(Waist to Eye: up to 54") 0 - 20 Lbs
CARRY
1-handed, 0 - 20 pounds
BEND FORWARD
at waist
KNEEL
(on knees)
STAND WALK
-
LEVEL SURFACE ROTATE TRUNK S
tanding
REACH
- Upward
PUSH
(0-20 pounds force)
PULL
(0-20 pounds force)
SIT CARRY
2-handed, 0 - 20 pounds
ROTATE TRUNK S
itting
REACH
- Forward
MANUAL DEXTERITY H
ands/wrists
FINGER DEXTERITY PINCH F
ingers
GRASP H
and/Fist None specified