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Job Title: Provider Education Coordinator
GENERAL SUMMARY:
- Directly coordinates, oversees, and controls the flow of provider education and medical record coded information required of the hospital and ambulatory sites for billing, reimbursement, and compliance purposes
- The Provider Education Coordinator serves as a subject matter expert for documentation and coding and utilizes expertise to analyze revenue cycle metrics to identify documentation trends for outlier providers and facilitates education work plans to improve the quality, completeness, timeliness, and accuracy of medical record documentation for professional and hospital services
- Serves as an educational resource and subject matter expert to providers and/or coding staff related to coding and documentation including, but not limited to local, State and Federal coding guidelines and regulations, NCCI Edits, ICD-10CM, CPT, Hierarchical Condition Categories (HCC), and standards of compliance
PRINCIPLE DUTIES AND RESPONSIBILITIES:
- Analyze individual provider and specialty coding and reimbursement reports/metrics and translate data into actionable education work plans for physicians, non-physician practitioners, residents, fellows, and ancillary staff
- Responsible for promoting improvements in documentation practices for assigned specialties through routine and rapid interaction with providers and specialties
- Facilitates education events, workshops, conferences, and presentations
- Distributes education materials, tools, and resources
- Involved with health system quality and core measure initiatives as they relate to documentation, coding, reimbursement, compliance, and workflow
- Oversees and regularly reports to department management on the status of departmental documentation and coding trends and mitigation strategies
- Monitors the availability, accuracy, and quality of all supporting medical documentation required for billing purposes and ensures that all necessary documentation is submitted on a timely basis
- Identifies patterns and trends in audit performance and query metrics to enable targeted education and improvement efforts
- Documents education activities and records meeting information in an access database
- Assists in the development, implementation, and monitoring of special projects
- Serves as the subject matter expert to assigned specialties and responds to inquiries and concerns expressed by providers or department administrators regarding documentation & coding
- Acts as a liaison between providers, department administrators and revenue cycle for documentation, coding, and reimbursement activities, projects, reporting, and communications
- Responsible to maintain current knowledge of applicable Federal, State, and local laws and regulations, the Organizational Integrity Program, Standards of Conduct, as well as other coding policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior
- Performs other related duties as required
QUALIFICATIONS:
Must Haves:
- Minimum 3 years of coding and billing experience
- Ability to Travel
- Must live within the state of Michigan within 1 hour of Troy, MI
- If outside of this radius, they will occasionally travel long distances
- Must have excellent communication skills, enjoy problem solving and teaching
Skills:
Must meet or exceed core customer service responsibilities, standards and behaviors as outlined in Our Client’s Customer Service Policy and summarized below:
- Communication
- Ownership
- Understanding
- Motivation
- Sensitivity
- Excellence
- Teamwork
- Respect
- Must practice the customer skills as provided through on-going training and in-services
Must possess the following personal qualities:
- Be self-directed
- Be flexible and committed to the team concept
- Demonstrate teamwork, initiative, and willingness to learn
- Be open to new learning experiences
- Accepts and respects diversity without judgment
- Demonstrates customer service values
PHYSICAL DEMANDS/WORKING CONDITIONS:
- Normal office environment with minimal exposure to noise, dust, or extreme temperatures
EDUCATION/EXPERIENCE REQUIRED:
- High School Diploma or G.E.D. equivalent required
- Associates Degree in Healthcare related field, Medical Record Sciences, or Business/Healthcare Administration or four (4) years coding experience may be
considered in lieu of education requirement
CERTIFICATIONS (Must have at least one):
- CPC, CCS, CCS-P, RHIT or RHIA
OpTech is an equal opportunity employer and is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, status as a parent, disability, age, veteran status, or other characteristics as defined by federal, state or local laws. https://www.optechus.com/eeo_self_identification/