Provider Services Auditor Educator

St. Luke’s University Health Network•Allentown, PA

22h

About The Position

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Provider Services Auditor & Educator is a certified medical coder who serves as a primary resource (auditor and educator) to assigned St. Luke’s Providers, Leadership, and Support Staff, Coders, and Billing Staff around professional coding and compliance. The Coding and Compliance Educator position is high profile and requires a candidate who is proactive, mature, dynamic, consistent with professional appearance and demeanor, and has the ability to develop and maintain positive strong relationships through challenging situations. This position requires a solid understanding of complex coding principles, guidelines, and concepts and can broadly apply those guidelines resulting in effective auditing and education to assigned services/departments, coding and billing teams. It also requires a broad exposure and knowledge of the general healthcare landscape and the historical and current trends across the healthcare revenue cycle spectrum.

Requirements

Active Certification of CPC, CCS-P required with working knowledge of ICD-10, CPT, and HCPCS coding.
5+ years of healthcare experience with exposure to pro fee coding and compliance

Nice To Haves

Advanced Degree strongly preferred but will consider quality experience
Clinical Credentials welcome but not required

Responsibilities

Assess, design, facilitate, develop, implement and evaluate coding and documentation efforts to ensure we achieve optimal coding outcomes and remaining complaint with the policies of the network, state, federal and third-party guidelines.
Organize, facilitate, perform, track, trend, and report on internal quality reviews based on compliance plan and/or independent data analysis.
Develop action plans working directly with providers and staff to address identified issues and improve overall documentation and coding.
Develop and deliver education in varied settings including large group presentations, classroom, small group forums, and 1:1, classroom, MEL for assigned departments/specialties.
Demonstrates expertise in teaching and learning process. Able to understand and flex communication style to meet the learning needs of the audience.
Serves as coding/documentation expert for assigned areas. Helps to resolve problems and recommends solutions, including documentation design in the EMR, where there is opportunity for improvement.
Maintains current knowledge of coding, compliance and documentation guidelines and trends for assigned departments/specialties.
Actively identifies opportunities for improvement, concerns, and trends and develops and implements action plans for such findings. Evaluates and communicates outcomes based on data and metrics chosen to demonstrate success of the plan.
Collaborates with medical staff to develop and implement education training associated with new technologies, procedures and quality related to coding and documentation.
Presents standard education modules including but not limited to new provider orientation
Conducts research using credible industry accepted sources to support and advance coding and documentation education and issues.
Extract and analyze complex data from various systems and turn into meaningful action based information for end users.
Uses credible data to drive decisions.