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Requisition Number 16-0087
Post Date 2/17/2017
Employment Type Full Time
Location Various
FLSA Non-Exempt
Title Lead Coding Physician Educator
City Kingsport
State TN
Description General Summary:
Serves as an internal auditor, educator, expert, liaison, and resource for all coding related matters within Holston Medical Group. Reviews and performs provider coding, billing and documentation audits for accuracy of ICD-10-CM, CPT, HCPCS codes, modifiers and charges to ensure coding compliance with all Regulatory Guidelines. Works with Management to provide coding and documentation education and shadowing support to providers and staff in concert with organizational goals related to correct coding and documentation. Provides on boarding education to newly hired providers. Serves as a resource to staff for coding questions and support.

Main Responsibilities:
• Analyzes all audit reports conducted by the third party compliance audit team to ensure adequate evidence is present to support audit findings and to identify any risk issues, revenue leakage and educational opportunities.
• Reviews the individualized audit report results, which should include accuracy and financial analysis, with the providers
• Identifies and determines that the integrity of coding and revenue generation is supported by the documentation. Escalates issues as appropriate to Quality Manager, Executive leadership, providers, clinical staff, coding staff, and other departments and provides recommendations accordingly. Assists in the assessment of impact of current compliance activities and risk evaluation
• Schedules and conducts coding education and follow-up audits as applicable
• Develops and performs coding education programs assessments for new providers on accurate coding assignment and coding policies according to CMS guidelines
• Shadows providers and works individually on coding documentation and templates
• Works closely with providers, leadership, coding staff and clinical staff. Communicates with providers, clinical staff when needed in order to address all needs and concerns in a timely manner
• Participates in decision making concerning policies and procedures as requested. Assists in writing and implementation of new policies and procedures
• Participates in committee work and on cross functional teams as requested by department management
• Participates in staff meetings, training and conference calls as requested
• Participates in workshops, seminars, audio conferences and other educational opportunities to insure continued learning for self-improvement
• Seeks out and analyzes opportunities to improve and enhance coding activities among staff
• Display customer service focused attitude and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession. Handles stressful situations with professionalism and tact
• Maintain strict patient and physician confidentiality and follow all federal, state and organization guidelines for release of information
• Maintain current working knowledge of CPT and ICD-10-CM coding principles, government regulation protocols and third party requirements regarding billing
Responsibilities as needed:
• Trains new team members of the department on their job role in coding, auditing and education
• Provides guidance and is a mentor for team members in the department on coding and auditing
• Oversees work flow of all team members of the department. Keeps Quality Manager informed of work accomplishments, status and issues
• Participates in interviewing potential team members. Also is involved in giving feedback on work performance to Quality Manager to assist in team member’s yearly evaluation

Disclaimer:
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
Requirements Education/Experience/Knowledge:
• High School diploma required. BS/AS degree preferred in Business/Healthcare
• Must be certified as an AAPC Certified Professional Coder (CPC) or an AHIMA Certified Coding Specialist (CCS)
• CPMA or other nationally recognized medical auditing certification preferred
• 5+ years’ experience coding
• 2+ years’ experience chart auditing
• Previous supervisory or team lead experience preferred
• Demonstrated auditing skills for coding quality and compliance
• Knowledge of CMS rules and regulations and current coding resources, including CPT, ICD-10, HCPCS, fee schedule
• Understanding of medical terminology, anatomy and physiology
• Computer skills to include Microsoft Office Windows, Excel, Word, and PowerPoint
• Exhibits high degree of accuracy and attention to detail in all documentation and correspondence
• Ability to work independently with minimal supervision
• Ability to prepare and present educational materials to providers in a group setting
• Strong communication and interpersonal abilities

Physical/Mental Demands:
Combination of walking, sitting, standing, bending, reaching, and lifting. Must be able to lift up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus. Occasional stress from balancing multiple tasks.

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An Equal Opportunity Employer