Mid Revenue Cycle Coding Educator Senior
About The Position
The Mid Revenue Cycle Coding Educator Senior serves as a subject matter expert and educational resource for medical record coding and patient charge issues. The role provides education and training to clinical providers, nurses, Revenue Integrity (RI) staff, and Health Information Management (HIM) staff. It develops and implements training in response to new processes, initiatives, coding projects, and business needs; plans audit and quality-review schedules; and communicates the operational impact of CMS changes. The position also conducts monthly audits and quality reviews, leads projects to improve clinical documentation and final coding for professional and technical billing, and reviews educational materials and onboarding programs prepared by other coding educators. The role ensures documentation of new team members' education program sign-off during their 90-day introductory period.
Requirements
- Bachelor's degree and six years of health care coding experience with ICD-10-CM, ICD-10-PCS, CPT, and HCPCS classification systems, including at least two years of professional-practice medical coding auditing or facility outpatient coding auditing experience; alternatively, an associate's degree with eight total years of the stated experience, or a high school diploma/GED with ten years of the stated experience.
- Hold at least one accepted certification: CCS, CPMA, CPC, COC, CCS-P, RHIT, RHIA, or CIC. Other certifications issued by the listed governing bodies may be reviewed and considered.
- Expertise in ICD-10-CM, ICD-10-PCS, CPT, HCPCS, AHA coding clinic guidelines, MS-DRG, APR-DRG, CMS guidelines, NCHS, radiation oncology coding guidance, and AHIMA and AAPC codes of ethics.
- Ability to communicate professionally with internal and external customers.
- Thorough understanding of how data quality affects prospective payment, utilization, and reimbursement across multiple medical specialties.
- Excellent communication and interpersonal skills.
- Experience with automated patient care and coding systems.
- Competence with Microsoft Office software, including Word, Excel, PowerPoint, OneNote, and Outlook.
- Experience with coding oncology-related services.
- Experience conducting training through Zoom.
Nice To Haves
- Experience with Cerner Electronic Health Record and Cerner products Radnet and Surginet, OPTUM Professional Computer Assisted Coding (pCAC), Patient Keeper, 3M encoder, Mosaiq, or Soarian financial billing system.
- Four years of experience coding oncology-related services.
Responsibilities
- Design, create, and implement educational and training curriculum for new processes, initiatives, coding-related projects, and general coding matters driven by business needs.
- Create the fiscal-year audit and quality-review schedule, including a contingency plan for unexpected reviews and external business priorities.
- Review and communicate CMS changes and their impact on Revenue Integrity and Health Information Management operations.
- Conduct monthly audits and quality reviews for providers, nurses, and RI and HIM staff to identify compliance opportunities involving clinical documentation, coding, and charging guidelines.
- Lead projects to review and improve clinical documentation and final coding for professional and technical billing, creating curriculum tailored to clinical services and individual stakeholders.
- Review and approve work completed by Mid Revenue Cycle Coding Educators before distribution, implementation, or use in educational venues.
- Review and approve the education and training calendar for onboarding new RI and HIM team members.
- Ensure sign-off of the education program is documented for new team members during their 90-day introductory period.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
