Clinical Coding Education Manager | South Portland, Maine

InterMed PA • South Portland, ME

91d

About The Position

The position involves designing and implementing education plans for physicians, Advanced Practice Providers (APPs), and staff related to procedural coding based on audit results and organizational initiatives and goals. The role includes coordinating with the Clinical Documentation Improvement Specialist (CDIS) team regarding diagnostic coding education, providing provider onboarding training, and offering ongoing continuous learning opportunities. The individual will serve as a subject matter expert in coding requirements related to new service lines, departments, and procedures, and will consult with Practice Managers, Billing and Finance, IT, and eCW teams to ensure compliance and documentation requirements are met for new services. Additionally, the role encompasses developing audit plans based on the annual coding compliance plan, coding guideline changes, coding trends, and OIG work plan, determining audit scope, presenting audit findings, and creating and monitoring corrective action plans.

Requirements

• Bachelor's Degree or equivalent relevant experience required; Business or Healthcare degree preferred.
• At least four years' revenue cycle experience required.
• In-depth knowledge of billing, coding, insurance practices, and ACO contracts.
• Excellent written and verbal communication skills.
• Ability to communicate effectively to all levels of the organization.
• Certified Professional Coder (CPC) certification or ability to obtain certification within one year from date of hire.

Responsibilities

• Designs and implements education plans for physicians, APPs, and staff related to procedural coding.
• Coordinates with the CDIS team regarding diagnostic coding education.
• Provides provider onboarding training and ongoing continuous learning opportunities.
• Serves as a subject matter expert in coding requirements for new service lines, departments, and procedures.
• Consults with Practice Managers, Billing and Finance, IT, and eCW teams to ensure compliance and documentation requirements.
• Develops audit plans based on annual coding compliance plan and coding guideline changes.
• Determines audit scope and presents findings to physicians, committees, and leadership.
• Creates and monitors corrective action plans per coding compliance plan.
• Evaluates and prioritizes coding audits/reviews and subsequent education based on changing guidelines.
• Supervises Coding Education Specialists and monitors their performance.
• Audits and reviews documentation against InterMed Policies and coding guidelines.
• Researches and summarizes rules, statutes, and regulations related to compliance, coding, and documentation.
• Defines and maintains the integrity of coding audit processes for the coding education team.
• Works collaboratively with various teams to ensure coding compliance and accuracy.
• Sets clear accuracy measures and productivity goals for the Coding Education Team.
• Responsible for hiring, training, managing, and evaluating team performance.

What This Job Offers

• Job Type: Full-time
• Industry: Ambulatory Health Care Services
• Education Level: Bachelor's degree