Professional Coding Educator/Auditor

Job Description

JOB TITLE: Professional Coding Educator/Auditor

DEPARTMENT: Billing Department

STATUS: Full-time

REPORTS TO: Director of Revenue Cycle Management

DATE: May 2024

POSITION SUMMARY: The Professional Coding Educator/Auditor provides educational and physician support for coding and billing practices. Managing annual provider audit process. Providing continuing education in coding and billing of specialty services and third-party regulations. This role will also act as a liaison between coding personnel and other staff groups—from clinicians to staff responsible for authorizations, billing, and denial management, as well as executive leadership.

DUTIES AND RESPONSIBILITIES:

• Maintains complete understanding of designated duties and responsibilities.
• Focusing on potential documentation improvement opportunities and issues by specialty for E&M, surgical, and ancillary clinicians.
• Creates and tailors all modules of a successful education process, including lesson plans and teaching materials for physicians, divisions, departments, as well as supporting providers such as PAs and NPs. (e.g. audiovisual aids, competency examinations, and presentations)
• Train new providers and faculty staff on E&M coding of their professional services, surgical coding of their professional specialty, and ancillary coding for authorization, approval, and denial remediation.
• Work with various leadership and clinical departments to design relevant trainings specific to an identified need of the clinical department as well as the direct communication, both virtual and onsite, with physicians to insure adequate training and conceptual mastery.
• Works with Revenue Cycle leadership and Compliance determine areas of both risk and opportunity as well as provide information and training on regulatory updates and standards to physician, providers, and centralized billing staff.
• Documents and maintains provider records to ensure annual/ new provider/ ad-hoc audits and training requirements are fulfilled.
• Always maintains a professional demeanor with patients, co-workers, providers and all leadership.
• Ability to use independent judgment and to manage and impart confidential information.
• Ability to multi-task and manage priorities and meet critical deadlines.
• Ability to work independently and in a fast-paced environment.
• High level of awareness of pertinent details; excellent organizational skills
• Accepts and integrates constructive criticism into daily work.
• Promotes a positive cooperative team approach with excellent patient interaction and customer service.
• Demonstrates regular, reliable, and predictable attendance.
• May be asked to assist with special projects.
• Maintain and model Premier Medical Groups mission, vision and Core values.
• Patient-Centered: Provide compassionate care and excellent service.
• Respectful: Respect co-workers and value each patient’s individuality and personal healthcare choices.
• Engaged: Demonstrate commitment, enthusiasm, and a positive attitude toward our work.
• Mentoring: Listen, share knowledge, and influence others in a positive way.
• Integrity: Practice the highest ethical standards, display honesty, be accountable and treat others fairly.
• Efficiency: Demonstrate proficiency in what we do; utilize time, resources, and finances appropriately.
• Resilience: Adapt and respond quickly to opportunities and risks in order to manage change and grow.
• Performs all other duties assigned.
  
  

EDUCATION AND WORK EXPERIENCE:

• Bachelor’s degree in a relevant field; Experience may substitute for education requirement.
• 6 years of related experience in a healthcare setting.
• Certified Professional Coder (AAPC, AHIMA)- Required
• Certified Medical Auditor Certification (AAPC)-Preferred
  
  
  

KNOWLEDGE AND SKILLS:

• Federal laws and regulations affecting coding requirements.
• Working knowledge of payor guidelines
• Knowledge of revenue cycle and billing practices
• Knowledge of Microsoft Suite
• Strong communication skills.
• Excellent interpersonal skills
• Organizational skills
• Denial Management
  
  
  

Premier Medical Group is an Equal Opportunity Employer

Salary : $32 - $38