Provider Coding and Informatics Educator (Outpatient)

District Medical Group•Phoenix, AZ

5d•Onsite

About The Position

Under the direction of the Director of Business Office Operations (DBOO), this position will review and analyze provider documentation related to diagnoses, procedures, and treatments within the electronic health system to identify opportunities, improvements, and barriers in charge automation and information exchange. This role will identify the appropriate systems and/or processes to optimize the use of information technology that support interface enhancements in the outpatient healthcare setting. This position will review, design, and provide in-person education and training to providers related to assigning ICD-10 and CPT coding, ensuring compliance with Federal, State, and payer regulations and understand the technology processes to enhance charge capture and decrease revenue leakage. The Provider Coding and Informatics Educator will develop education based on provider specialty and location and serve as the primary resource to providers for documentation and coding issues.

Requirements

High school diploma or equivalent required
Certified Coding Specialist (CCS), Certified Professional Coder (CPC) required
Minimum of four (4) years’ experience outpatient medical coding, preferably for a Level One and Teaching Hospital, Multi-Specialty outpatient facility
Two (2) years’ experience clinical documentation improvement, chart review, and coding physician services
Extensive knowledge in ICD-10-CM and CPT coding, guidelines, anatomy, physiology and medical terminology
Knowledge of Medicare/Medicaid and other government regulations surrounding documentation, coding, and medical billing practices
Ability to understand the clinical content of medical records and technology platforms
Have excellent communication, documentation, and presentation skills to interact and communicate effectively with providers and other staff
Ability to explain information in a clear, concise, and organized format
Ability to manage time efficiently and multi-task expectations and responsibilities
Position is required to be present on DMG or Valleywise location(s) to complete job duties such as in-person training

Nice To Haves

Experience in Revenue Cycle Management (medical billing) preferred
Prior experience with Athena/IDX, EPIC, Encoder Pro preferred

Responsibilities

Provide clinical documentation review and clinical information systems education to support accurate coding and regulatory compliance.
Identify patterns, trends, variations, and barriers in coding and documentation practices to ensure all care delivery services are accounted for in health information exchange and charge automation.
Work closely with information systems regarding charge automation and technology enhancements.
Attend and provide coding and documentation information sessions to Physician/Provider and Clinic/Site Department meetings.
Conduct Physician/Provider education that include coding and/or documentation topics, such as documentation by Specialist Provider, online review meetings, and Revenue Cycle Management division meetings.
Review and provide coding and/or documentation guidance; initiates updates to record or EMR templates.
Communicate Physician/Provider new services to DBOO and/or Revenue Cycle Management and facility EMR partners
Identify and/or prompt clinical documentation improvement (CDI) and charge capture efficiency and opportunities.
Independently support and maintain Physician/Provider, RCM, and facility informatics relationships as the point of contact.
Maintain current knowledge of Medicare, Medicaid, and other regulatory requirements pertaining to nationally accepted coding policies and standards.
Take ownership of special projects, research data and follows through with detailed action plans.
Analyze interface information to enhance charge capture.
Design, develop, and deliver education programs, including training and support materials, tailored to provider specialty and applications.
Analyze and report on charting processes.
Collaborate with educators and subject matter experts.
Collect and coordinate the collection of data by performing coding quality chart reviews, ensuring the reviews meet government, regulatory, and coding guidelines/standards.
Deliver chart review results with accurate and relevant reports that can be used to make informed business decisions.
Other duties as assigned.

Benefits

Medical, Dental, Vision, and many additional ancillary benefits EFFECTIVE DAY ONE
401(k) contribution options, with employer match up to 6%
Access to Retirement Advisors
Employer-paid Disability
A Health Savings Account option with employer contribution
Flexible Spending Account options, including Dependent Care FSA
Rich Wellness Program and EAP, at no cost to the employee
Fitness location memberships
Pet care discount program
Generous PTO allocation, increasing after 3 years
10 paid Holidays
Up to 40 hours Paid Sick Time annually