PB Coding Coordinator
About The Position
The Medical Group PB Coding Coordinator is responsible for overseeing and ensuring the accuracy and compliance of medical coding and serving as the subject matter expert for the assigned team within the medical group. This role involves navigating the Epic Electronic Medical Record (EMR) system, resolving coding edits, reviewing medical documentation, and providing education and training to medical providers and coders. Essential Functions Serve as the subject matter expert for assigned specialties and provide ongoing coding education/training for clinical providers, clinic operations, and coders, ensure compliance with coding regulations and guidelines pertaining to specialty area, and assist coding leadership in crafting communications, tip sheets and workflows. Assists in onboarding and training of new coders within assigned specialty areas. Accurately evaluates and resolves coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic. Evaluates and resolves all types of coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic, as applicable/assigned. Assigns E/M levels of service, procedural CPT codes, and HCPCS codes and any applicable modifiers based on documentation for inpatient and outpatient settings, as applicable for assigned specialty. Works with coding leadership to address or resolve coding/denial trends. Communicates with providers via Epic in-basket message and email per departmental guidelines. Performs quality assurance audits (standard, surgical, and E/M) for coders within assigned specialty team. Completes special projects, monitor and evaluate coding workflows in order to identify opportunities for improvement and increased efficiency. Utilizes coding knowledge and source-based research to investigate and respond to coding requests related to their specialty area (i.e. customer service requests, Epic CRMs, 3rd party system reviews etc). Utilizes organizational and departmental tools as applicable (i.e. Microsoft Office Suite products, Kronos, ServiceHub, Optum Encoder Pro, etc.). Effectively navigates Epic EMR, including applicable reports and work queues.
Requirements
- Medicare coding guidelines (i.e. NCCI, LCD/NCD)
- CPT
- HCPCS
- ICD-10
- Epic PB Resolute
- Accuracy
- Detail oriented
- Collaborative
- Communication
- Demonstrated experience in professional fee coding including Evaluation & Management services and coding for the specific specialty service line
- Certified Professional Coder (CPC) or Certified Coding Specialist Physician (CCS-P) credential
- Demonstrated knowledge of training/education techniques.
Nice To Haves
- High School Diploma or equivalent
- Five (5) years of professional fee coding experience
- Three (3) years of experience coding within the assigned specialty service line
- Related specialty coding credential
- Epic experience
Responsibilities
- Serve as the subject matter expert for assigned specialties and provide ongoing coding education/training for clinical providers, clinic operations, and coders, ensure compliance with coding regulations and guidelines pertaining to specialty area, and assist coding leadership in crafting communications, tip sheets and workflows.
- Assists in onboarding and training of new coders within assigned specialty areas.
- Accurately evaluates and resolves coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic.
- Evaluates and resolves all types of coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic, as applicable/assigned.
- Assigns E/M levels of service, procedural CPT codes, and HCPCS codes and any applicable modifiers based on documentation for inpatient and outpatient settings, as applicable for assigned specialty.
- Works with coding leadership to address or resolve coding/denial trends.
- Communicates with providers via Epic in-basket message and email per departmental guidelines.
- Performs quality assurance audits (standard, surgical, and E/M) for coders within assigned specialty team.
- Completes special projects, monitor and evaluate coding workflows in order to identify opportunities for improvement and increased efficiency.
- Utilizes coding knowledge and source-based research to investigate and respond to coding requests related to their specialty area (i.e. customer service requests, Epic CRMs, 3rd party system reviews etc).
- Utilizes organizational and departmental tools as applicable (i.e. Microsoft Office Suite products, Kronos, ServiceHub, Optum Encoder Pro, etc.).
- Effectively navigates Epic EMR, including applicable reports and work queues.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
