Professional Coding Audit Educator

Yale New Haven Health • New Haven, CT

2d

About The Position

The Professional Coding Audit Educator is an essential member of the Professional Coding Leadership Team and serves as the department subject matter expert in professional coding. The role supports physicians, practices, coders, and coding and operational leadership by developing an educational pathway that helps professional coders improve their accuracy and knowledge. The educator develops and maintains the professional coding education program for coders, clinicians, and others within the professional revenue cycle.

The position also conducts audits to assess risk, develops and implements action plans based on findings, and helps establish and maintain coding-compliant controls to promote consistent and accurate coding and optimal charge capture. The role requires expertise in professional coding, strong presentation and curriculum-development skills, and the ability to work with individuals throughout the health system, particularly physicians and practice leadership.

Requirements

• Bachelor's degree or current enrollment in a bachelor's degree program.
• Five or more years of coding and/or coding audit educator work experience; an AAPC Certified Instructor credential may substitute for two years of work-related experience.
• Expert subject matter coding knowledge, including in-depth understanding of applicable coding guidelines, payment methodology, CMS regulations, and use of coding resources to research and answer questions.
• Past experience with training and education in large and small groups, working with physicians, and developing training materials and coding curriculum.
• CPC (Certified Professional Coder) credential through AAPC.
• Have or obtain an AAPC coding instructor designation within six months of hire.
• Ability to work under minimal supervision and prioritize departmental educational needs while supporting clinicians and other health system areas.
• Strong presentation skills and ability to develop customized coding curriculum and deliver training clearly, logically, and informatively.
• Ability to work with individuals at all levels of the health system, especially physicians and practice leadership.
• Organized and meticulous approach to documentation and reviews.

Nice To Haves

• Epic experience.
• Additional coding specialty credentials.

Responsibilities

• Educate and provide direction to providers and coding staff on proper CPT, ICD-10, and HCPC coding, serving as a subject matter expert on professional fee and professional coding rules and regulations.
• Review and respond in a timely manner to coding questions from physicians, coding staff, and practice or operations leadership.
• Facilitate virtual events, calls, and training to address coding needs and requests related to charging, documentation, and compliant coding.
• Create and maintain training materials and educate providers, coders, and other coding professionals on coding topics, including developing and rolling out curriculum, workflows, tip sheets, coding policies, and physician communication (query) templates in conjunction with coding leadership.
• Deliver training through a variety of formats, including one-to-one, small-group, large-group, webinar-style, and live education.
• Track audit education program efforts, including trainings, policies, procedures, audits, and staff certifications, and regularly communicate the status of educational initiatives, department accuracy, and additional education needs to department leadership.
• Assess new and existing coder skillsets, develop onboarding and ongoing skill-development training, and report findings and recommendations to coding leadership.
• Develop follow-up educational plans based on individual performance and challenges, and lead apprentice initiatives.
• Review charging to identify opportunities for charge capture, ICD-10 specificity, denial prevention, and proper coding for professional services; provide feedback, guidance, and education to support optimal charging and workflows.
• Develop action plans to improve department accuracy and share information about physician workflow opportunities.
• Perform coding audits as needed to meet compliance requirements and client expectations, determine when additional education is necessary, and assist the education team in meeting those needs.
• Develop a department audit workplan to mitigate risk, assess areas of opportunity, and implement corrective actions.

What This Job Offers

• Job Type: Full-time