Physician Services Coding Educator

Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

To assist the Manager of Physician Coding and Compliance by monitoring the audit and coding activities for the physicians employed and or contracted by Northside. Monitors and works toward accurate code selection by minimizing denial issues so appropriate reimbursement for the services provided is attained.  Works with the Management Team to educate physicians on coding and documentation compliance.

PRIMARY DUTIES AND RESPONSIBILITIES

1. Manages and develops a detailed education plan based on audit areas being reviewed by maintaining a close working relationship with Compliance to meet established goals and responsibilities of maintaining consistent quality monitoring processes to validate coding and billing accuracy that minimize denials.
2. Manages and monitors the progress of developed action plans by developing and administering coding education program(s) that ensure providers and staff maintain coding and billing competencies and are current with coding requirements and regulations,  and acting as coding and billing compliance resource for the employed physicians Northside and their staff
3. Provide physician feedback, initial and ongoing education and training.  Lends technical support in regards to proper clinical documentation guidelines, service selection, charge capture and timely submission, healthcare data accuracy and coding principles.
4. Collaborates with Revenue Integrity Coordinators Supervisors, Analysts, as well as Practice Managers, to identify and develop new processes, software development and provider training opportunities based on audit results.
5. Coordinates the coding intern program within Revenue Integrity to ensure program success facilitating placement within the physician practices to fill coding gap/void.
6. Serves as a subject matter expert on interpretation and application of documentation and coding rules, regulations and conduct risk assessments of potential and detected compliance deficiencies.
7. Based on feedback from external and internal physician audit results, and accuracy expectations as determined to maintain correct coding standards, coordinate the educational opportunities for the assigned direct-care providers in regards to the medical and legal aspects of professional coding and documentation requirements.
8. Assist with developing and implementing recommendations for changes in policies and procedures relevant to correct and compliant coding.
9. Serves as a resource for physicians, billing and coding staff as well as administrative staff relative to technical guidance on professional coding issues.
10. Stays current with all coding changes and updates through regular research and verification.
11. Utilizes available resources and continuing education programs to remain knowledgeable and current with coding and billing compliance regulations.  Meets annual requirements to maintain CPC or CCS-P certification.
12. Ability to interact with physicians and non-physician practitioners.
13. Maintains confidentiality of all findings and materials reviewed.
14. Practices proper safety techniques in accordance with hospital and departmental policies and procedures.
15. Immediately reports any mechanical or electrical equipment malfunctions, employee/patient/visitor injuries or accidents, or other safety issues to supervisor or Compliance Office.
16. Provides customer service routinely in interactions with customers such as coworkers, patients, visitors, physicians, and volunteers.

KNOWLEDGE SKILLS AND ABILITIES/LICENSE OR CERTIFICATION REQUIRED

1. Minimum of Five (5) years of coding supervisory/management experience including three (3) years relevant experience with physician practice coding, documentation, billing, and/or reimbursement.
2. CCS-P or CPC certification required.
3. CPMA (Certified Professional Medical Auditor) required
4. CPC-I required